Differences in the treatment and evolution of acute coronary syndromes according to gender: what are the causes?
| Autor: | Berta Ibañez-Beroiz, Tomás Belzunegui-Otano, Marta Ferraz-Torres, Blanca Marín-Fernández, Ó. Martínez-García |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Medical care Coronary artery disease Sex Factors Internal medicine Epidemiology Fibrinolysis Health care Female patient medicine Humans Prospective Studies Acute Coronary Syndrome Angioplasty Balloon Coronary Prospective cohort study General Nursing Aged business.industry General Medicine Middle Aged medicine.disease Spain Physical therapy Female Health education Emergency Service Hospital business Delivery of Health Care |
| Zdroj: | Journal of Clinical Nursing. 24:2468-2477 |
| ISSN: | 0962-1067 |
| DOI: | 10.1111/jocn.12831 |
| Popis: | Aims and objectives. The objectives of this study were to analyse the differences in the treatment and the evolution of acute coronary syndromes according to the gender of the patient and to determine the likely causes of these differences. Background. Epidemiological studies confirm the differences in the course and treatment of acute coronary syndromes according to factors such as gender and age. The factors associated with the observed gender-based differences are not known. Design and methods. This prospective study was conducted on 596 patients treated in the Hospital Emergency Service of the Hospital Complex of Navarra, Spain, from 1 January 2012 to April 2013 with acute coronary syndromes. A bivariate and logistic analysis has been made by adjusting the age and severity of process to know the differences by gender. Results. A total of 71� 8% (n = 428) were men, and the remaining 28� 2% (168) were women. The mean age of the men was 66� 4 � 12� 7 years, and the mean age of the women was 72� 5 � 13� 9 years. We found that antiplatelet drugs (68� 4 vs. 22� 7%), blockers (70 vs. 25� 4%), ACE inhibitors (56� 2 vs. 15� 6%), fibrinolysis (17� 2 vs. 4� 5%, p = 0� 025) and primary angioplasty (AP) (38� 7 vs. 16� 3%, p = 0� 008) were less frequently administered to women compared with men. We observed an additional delay in the demand for health care in women with acute coronary syndromes compared with men. Conclusions. There is an association between treatment differences and gender. The delay in the request of health care in women is observed to be the largest correlating factor, in addition to voluntary discharge in women affected by acute coronary syndromes. Relevance to clinical practice. Delays in seeking medical care or voluntary discharge are likely factors related to worse outcomes in women. These factors should be explored, and the results should be made available to the public, particularly to women. What does this paper contribute to the wider global clinical community? The different performance observed in patients with ACS according to gender allows us to tailor our professional attitude and behaviour. It allows us to customise the health education of nurses providing care to these patients to emphasise the importance of coronary artery disease for both genders and the immediacy of treatment. Delaying the treatment of female patients with ACS may be a likely cause of worse outcomes, and differentiating treatment according to gender allows us to study cases and aims to improve health care in nursing and medicine. |
| Databáze: | OpenAIRE |
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