Sex-Related Differences in Mortality, Delayed Cerebral Ischemia, and Functional Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis

Berli, Sarah; Barbagallo, Massimo; Keller, Emanuela; Esposito, Giuseppe; Pagnamenta, Alberto; Brandi, Giovanna

doi:10.3390/jcm13102781

Cited by 2 publications

(1 citation statement)

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“…There are well- known sex related differences in the epidemiology as well as treatment of SAH patients [ 25 , 26 ]. Moreover, women have an higher risk of delayed cerebral ischemia in comparison to men [ 27 ], even though there is no difference in the development of an infarction or functional outcomes [ 28 , 29 ]. Based on local protocols, higher partial pressure of oxygen (pO2) targets are aimed in patients with SAH to reduce the specific risk of delayed cerebral ischemia (DCI).…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the use of mechanical ventilation in a neurointensive care population: a retrospective study

Stretti,

Utebay,

Bögli

et al. 2024

BMC Pulm Med

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Background In the general intensive care unit (ICU) women receive invasive mechanical ventilation (IMV) less frequently than men. We investigated whether sex differences in the use of IMV also exist in the neurocritical care unit (NCCU), where patients are intubated not only due to respiratory failure but also due to neurological impairment. Methods This retrospective single-centre study included adults admitted to the NCCU of the University Hospital Zurich between January 2018 and August 2021 with neurological or neurosurgical main diagnosis. We collected data on demographics, intubation, re-intubation, tracheotomy, and duration of IMV or other forms of respiratory support from the Swiss ICU registry or the medical records. A descriptive statistics was performed. Baseline and outcome characteristics were compared by sex in the whole population and in subgroup analysis. Results Overall, 963 patients were included. No differences between sexes in the use and duration of IMV, frequency of emergency or planned intubations, tracheostomy were found. The duration of oxygen support was longer in women (men 2 [2, 4] vs. women 3 [1, 6] days, p = 0.018), who were more often admitted due to subarachnoid hemorrhage (SAH). No difference could be found after correction for age, diagnosis of admission and severity of disease. Conclusion In this NCCU population and differently from the general ICU population, we found no difference by sex in the frequency and duration of IMV, intubation, reintubation, tracheotomy and non-invasive ventilation support. These results suggest that the differences in provision of care by sex reported in the general ICU population may be diagnosis-dependent. The difference in duration of oxygen supplementation observed in our population can be explained by the higher prevalence of SAH in women, where we aim for higher oxygenation targets due to the specific risk of vasospasm.

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