TORNA ALL’ELENCO

Sex differences in use of interventional cardiology persist after risk adjustment in Journal of Epidemiology and Community Health

2009
ASL Cuneo 1

Tipo pubblicazione

Article

Autori/Collaboratori (6)Vedi tutti...

McKee M
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom
Moirano F
Local Health Agency, Cuneo, Mondovi and Savigliano, Piedmont Region, Italy
Bertetto O
Regional Agency for Health Services of Piedmont, Piedmont Region, Turin, Italy

et alii...

Abstract

Background: Studies from several countries have documented gender disparities in the management of coronary artery disease. Whether such gender disparities are seen in Italy and, if so, whether they can be explained by factors such as age and severity of illness were investigated. Methods: 77 974 Piedmontese patients, admitted between 1999 and 2002, with a primary diagnosis of myocardial infarction (ICD 410), angina (ICD 413), chronic ischaemia (ICD 414) and chest pain (ICD 786.5) were studied. The number of men and women undergoing surgical treatment was extracted and the male-female odds ratios calculated. Several risk factors and a risk adjustment technique (APFi-DFiG) were used to control for possible confounders. Backward stepwise multiple logistic regression was used to adjust for significant covariates. Results: Crude analysis demonstrated that gender is a discriminating factor in the probability of surgery (OR 2.11, 95% CI 2.04 to 2.19), with similar findings among those with each main diagnosis. The odds ratios decreased after adjustment for age, co-morbidity and disease severity but remained significant. Conclusions: Men and women admitted to hospitals in a region of northern Italy with a diagnosis of cardiovascular disease are treated differently and this cannot be explained by age or severity of disease.

DOI : 10.1136/jech.2008.077537

Keywords

thorax pain; surgery; sex difference; risk factor; risk assessment; risk; patient; multivariate logistic regression analysis; morbidity; male; Italy; ischemia; hospital; heart infarction; general aspects of disease; gender; female; disease severity; diagnosis; coronary artery disease; angina pectoris; cardiology; cardiovascular disease;