1987年から2011年までのアメリカ社会における脳卒中の発生率と死亡率の動向, 1987年から2011年
Silvia Koton1, Andrea L C Schneider2, Wayne D Rosamond3
1Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel2Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland.
JAMA
|July 17, 2014
まとめ
1987年から2011年にかけて,黒人と白人の成人の脳卒中の発生率と死亡率は減少しました. これらの脳卒中治療の改善と結果は,2011年まで続いたが,さまざまな年齢層で変化が観察された.
科学分野:
- 神経学 神経学とは
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 以前の研究では,脳卒中による死亡率が減少していることが示されていますが,検証された脳卒中発生率と長期的な人種的傾向に関するデータは依然として限られています.
- これらの傾向を理解することは,標的を絞った公衆衛生の介入と医療資源の配分に不可欠です.
研究 の 目的:
- 黒人および白人成人の脳卒中発生率およびその後の死亡率の時間的傾向を調査する.
- 1987年から2011年のAtherosclerosis Risk in Communities (ARIC) コホートにおけるこれらの傾向を分析する.
主な方法:
- 予見的なコホート研究では,発症時点での脳卒中のない参加者14,357人を対象に,282,097人年間追跡調査を行った.
- データ収集には,基礎心血管リスク因子,脳卒中入院,および死亡率の関連性と国家死亡指数が含まれていました.
- 脳卒中事件は判定され,発生率と死亡率の傾向は,それぞれPoissonとCoxの回帰モデルを使用して分析されました.
主要な成果:
- 脳卒中の発生率は,黒人と白人の両方で時間とともに減少しました (年齢調整された10年あたりのIRR:0.76),65歳以上の人ではより顕著に減少しました.
- 脳卒中後の全体的な死亡率は,特に65歳未満の個体では,時間の経過とともに減少しました (HR: 0.80).
- 発症率と死亡率の減少は,性別と人種間で類似していましたが,発症傾向は年齢層によって異なります.
結論:
- 1987年から2011年の間に,米国コミュニティの黒人と白人の成人の間で脳卒中の発生率と死亡率は著しく低下しました.
- これらの発見は,脳卒中予防と管理の継続的な改善を示しており,21世紀初頭まで拡大しています.
- 改善は人種と性別にわたって一貫していましたが,年齢特有の変動は,カスタマイズされた戦略の必要性を強調しています.
さらに関連する動画
09:49Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
3.3K
11:28A Coupled Experiment-finite Element Modeling Methodology for Assessing High Strain Rate Mechanical Response of Soft Biomaterials
Published on: May 18, 2015
11.8K
関連する概念動画
01:08Prevalence and Incidence
2.3K
In statistical epidemiology and health sciences, two essential metrics—prevalence and incidence—are fundamental for understanding disease dynamics within a population. These measures enable public health officials, epidemiologists, and researchers to assess the burden of diseases, allocate resources effectively, and design impactful public health policies and interventions.
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
2.3K
01:29Bias in Epidemiological Studies
1.6K
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
1.6K
01:25Statistical Methods for Analyzing Epidemiological Data
1.3K
Epidemiological data primarily involves information on specific populations' occurrence, distribution, and determinants of health and diseases. This data is crucial for understanding disease patterns and impacts, aiding public health decision-making and disease prevention strategies. The analysis of epidemiological data employs various statistical methods to interpret health-related data effectively. Here are some commonly used methods:
1.3K
01:20Actuarial Approach
384
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
384
01:09Changes in the Appendicular Skeleton with Age
3.2K
The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
3.2K
01:21Types of Reports II: Incident or Occurrence Report
1.3K
An Incident or Occurrence Report in a healthcare setting is a crucial document used to record any unexpected occurrence that may or may not have affected a patient, employee, or visitor. Such reports are critical to improving patient safety and include all details leading up to and including the event.
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
1.3K