For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
6
views
20
references
 Top references
cited by
11
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      297
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Sex-Related Differences in Patients’ Characteristics, Provided Care, and Outcomes Following Spontaneous Intracerebral Hemorrhage

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Sex-related differences in patients with spontaneous, non-traumatic intracerebral hemorrhage (ICH) are poorly investigated so far. This study elucidates whether sex-related differences in ICH care in a neurocritical care setting exist, particularly regarding provided care, while also taking patient characteristics, and outcomes into account.

          Methods

          This retrospective single center study includes all consecutive patients with spontaneous ICH admitted to the neurocritical care unit in a 10-year period. Patients’ demographics, comorbidities, symptoms at presentation, radiological findings, surgical and medical provided care, intensive care unit mortality and 12 month-mortality, and functional outcome at discharge were compared among men and women.

          Results

          Overall, 398 patients were included (male = 198 and female = 200). No differences in demographics, Charlson Comorbidity Index (CCI), symptoms at presentation, radiological findings, intensive care unit mortality and 12-month mortality were observed among men and women. Men received an external ventricular drain (EVD) for hydrocephalus-therapy significantly more often than women, despite similar location of the ICH and radiographic parameters. In the multivariate analysis, EVD insertion was independently associated with male sex (odds ratio 2.82, 95% confidence interval 1.61–4.95, P < 0.001) irrespective of demographic or radiological features. Functional outcome after ICH as assessed by the modified Rankin scale, was more favorable for women ( P = 0.044).

          Conclusions

          Sex-related differences in patients with ICH regarding to provided neurosurgical care exist. We provide evidence that insertion of EVD is associated with male sex, disregarding clear reasoning. A sex-bias as well as social factors may play a significant role in decision-making for the insertion of an EVD.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: found
          • Article: not found

          Sex differences in stroke epidemiology: a systematic review.

          Peter Appelros, Birgitta Stegmayr, Andreas Terént (2009)
          Epidemiological studies, mainly based on Western European surveys, have shown that stroke is more common in men than in women. In recent years, sex-specific data on stroke incidence, prevalence, subtypes, severity and case-fatality have become available from other parts of the world. The purpose of this article is to give a worldwide review on sex differences in stroke epidemiology. We searched PubMed, tables-of-contents, review articles, and reference lists for community-based studies including information on sex differences. In some areas, such as secular trends, ischemic subtypes and stroke severity, noncommunity-based studies were also reviewed. Male/female ratios were calculated. We found 98 articles that contained relevant sex-specific information, including 59 incidence studies from 19 countries and 5 continents. The mean age at first-ever stroke was 68.6 years among men, and 72.9 years among women. Male stroke incidence rate was 33% higher and stroke prevalence was 41% higher than the female, with large variations between age bands and between populations. The incidence rates of brain infarction and intracerebral hemorrhage were higher among men, whereas the rate of subarachnoidal hemorrhage was higher among women, although this difference was not statistically significant. Stroke tended to be more severe in women, with a 1-month case fatality of 24.7% compared with 19.7% for men. Worldwide, stroke is more common among men, but women are more severely ill. The mismatch between the sexes is larger than previously described.
          Article 0 comments Cited 314 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Practical considerations on the use of the Charlson comorbidity index with administrative data bases.

            William D'Hoore, André Bouckaert, Charles Tilquin (1996)
            To develop a measure of the burden of comorbid disease from the MED-ECHO data base (Québec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in 33,940 patients with ischemic heart disease. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index. Various transformations of the comorbidity score were performed, and their effect on the predictive accuracy was assessed. The comorbidity index was constantly and strongly associated with death. From a statistical viewpoint, the best results were obtained when the index was transformed into four dummy independent variables (the area under the receiver-operating curve is then 0.87). In a validation analysis performed on 1990-1991 MED-ECHO data (36,012 admissions with ischemic heart disease), the comorbidity index has the same statistical properties. We conclude that the Charlson index may be an efficient approach to risk adjustment from administrative data bases, although it should be tested on other conditions.
            Article 0 comments Cited 102 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Predictors of intensive care unit refusal in French intensive care units: a multiple-center study.

              Luc Montuclard, Jean Reignier, S Boussat … (2005)
              To identify factors associated with granting or refusing intensive care unit (ICU) admission, to analyze ICU characteristics and triage decisions, and to describe mortality in admitted and refused patients. Observational, prospective, multiple-center study. Four university hospitals and seven primary-care hospitals in France. None. Age, underlying diseases (McCabe score and Knaus class), dependency, hospital mortality, and ICU characteristics were recorded. The crude ICU refusal rate was 23.8% (137/574), with variations from 7.1% to 63.1%. The reasons for refusal were too well to benefit (76/137, 55.4%), too sick to benefit (51/137, 37.2%), unit too busy (9/137, 6.5%), and refusal by the family (1/137). In logistic regression analyses, two patient-related factors were associated with ICU refusal: dependency (odds ratio [OR], 14.20; 95% confidence interval [CI], 5.27-38.25; p < .0001) and metastatic cancer (OR, 5.82; 95% CI, 2.22-15.28). Other risk factors were organizational, namely, full unit (OR, 3.16; 95% CI, 1.88-5.31), center (OR, 3.81; 95% CI, 2.27-6.39), phone admission (OR, 0.23; 95% CI, 0.14-0.40), and daytime admission (OR, 0.52; 95% CI, 0.32-0.84). The Standardized Mortality Ratio was 1.41 (95% CI, 1.19-1.69) for immediately admitted patients, 1.75 (95% CI, 1.60-1.84) for refused patients, and 1.03 (95% CI, 0.28-1.75) for later-admitted patients. ICU refusal rates varied greatly across ICUs and were dependent on both patient and organizational factors. Efforts to define ethically optimal ICU admission policies might lead to greater homogeneity in refusal rates, although case-mix variations would be expected to leave an irreducible amount of variation across ICUs.
              Article 0 comments Cited 69 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Sophie Shih-Yüng Wang: sophie.wang@med.uni-tuebingen.de
                Journal
                Journal ID (nlm-ta): Neurocrit Care
                Journal ID (iso-abbrev): Neurocrit Care
                Title: Neurocritical Care
                Publisher: Springer US (New York )
                ISSN (Print): 1541-6933
                ISSN (Electronic): 1556-0961
                Publication date (Electronic): 7 April 2022
                Publication date PMC-release: 7 April 2022
                Publication date (Print): 2022
                Volume: 37
                Issue: 1
                Pages: 111-120
                Affiliations
                [1 ]GRID grid.10392.39, ISNI 0000 0001 2190 1447, Department of Neurosurgery and Neurotechnology, , Eberhard Karls University Tübingen, ; Hoppe-Seyler-Strasse 3, 72070 Tübingen, Germany
                [2 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Institute for Intensive Care Medicine, , University Hospital Zurich, ; Zurich, Switzerland
                [3 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Department of Neurology, , University Hospital Zurich, ; Zurich, Switzerland
                [4 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Department of Diagnostic and Interventional Radiology, , University Hospital of Zurich, ; Zurich, Switzerland
                [5 ]GRID grid.7400.3, ISNI 0000 0004 1937 0650, Department of Neurosurgery and Clinical Neuroscience Center, , University Hospital and University of Zurich, ; Zurich, Switzerland
                Article
                Publisher ID: 1453
                DOI: 10.1007/s12028-022-01453-y
                PMC ID: 9283357
                PubMed ID: 35386067
                SO-VID: 4d3db7f6-088e-4115-a011-f61ff72dca57
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 17 August 2021
                Date accepted : 18 January 2022
                Funding
                Funded by: University of Zurich
                Open Access :

                Open access funding provided by University of Zurich

                Categories
                Subject: Original Work
                Custom metadata
                issue-copyright-statement © Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2022

                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: intracerebral hemorrhage,gender medicine,stroke,intensive care
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: intracerebral hemorrhage, gender medicine, stroke, intensive care

                Comments

                Comment on this article

                scite_

                Similar content297

                See all similar

                Cited by11

                See all cited by

                Most referenced authors214

                See all reference authors