| Autor: |
Berli S; Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland.; Neurocritical Care Unit, Department of Neurosurgery, Institute for Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Barbagallo M; Neurocritical Care Unit, Department of Neurosurgery, Institute for Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland., Keller E; Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland.; Neurocritical Care Unit, Department of Neurosurgery, Institute for Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.; Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland., Esposito G; Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland.; Department of Neurosurgery, University Hospital Zurich, 8091 Zurich, Switzerland., Pagnamenta A; Clinical Trial Unit, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.; Department of Intensive Care, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.; Division of Pneumology, University of Geneva, 1211 Geneva, Switzerland., Brandi G; Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland.; Neurocritical Care Unit, Department of Neurosurgery, Institute for Intensive Care Medicine, University Hospital Zurich, 8091 Zurich, Switzerland. |
| Abstrakt: |
Background/Objective : Sex-related differences among patients with aneurysmal subarachnoid hemorrhage (aSAH) and their potential clinical implications have been insufficiently investigated. To address this knowledge gap, we conduct a comprehensive systematic review and meta-analysis. Methods : Sex-specific differences in patients with aSAH, including mortality, delayed cerebral ischemia (DCI), and functional outcomes were assessed. The functional outcome was dichotomized into favorable or unfavorable based on the modified Rankin Scale (mRS), Glasgow Outcome Scale (GOS), and Glasgow Outcome Scale Extended (GOSE). Results : Overall, 2823 studies were identified in EMBASE, MEDLINE, PubMed, and by manual search on 14 February 2024. After an initial assessment, 74 studies were included in the meta-analysis. In the analysis of mortality, including 18,534 aSAH patients, no statistically significant differences could be detected (risk ratio (RR) 0.99; 95% CI, 0.90-1.09; p = 0.91). In contrast, the risk analysis for DCI, including 23,864 aSAH patients, showed an 11% relative risk reduction in DCI in males versus females (RR, 0.89; 95% CI, 0.81-0.97; p = 0.01). The functional outcome analysis (favorable vs. unfavorable), including 7739 aSAH patients, showed a tendency towards better functional outcomes in men than women; however, this did not reach statistical significance (RR, 1.02; 95% CI, 0.98-1.07; p = 0.34). Conclusions : In conclusion, the available data suggest that sex/gender may play a significant role in the risk of DCI in patients with aSAH, emphasizing the need for sex-specific management strategies. |
