邻里社会经济背景和心肌梗塞后的长期存活率
Yariv Gerber1, Yael Benyamini, Uri Goldbourt
1Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel. yarivg@post.tau.ac.il
Circulation
|January 13, 2010
概括
社区的社会经济地位 (SES) 显著影响心肌梗塞 (MI) 后的存活率. 即使考虑到个人因素,生活在贫困地区也会增加心脏病发作患者的死亡风险.
科学领域:
- 心血管流行病学心血管流行病学
- 健康的社会决定因素
- 公共卫生 公共卫生
背景情况:
- 邻里社会经济地位 (SES) 可能会影响心血管风险,独立于个人的SES.
- 关于社区SES对心肌梗塞 (MI) 患者结果的影响的数据有限.
研究的目的:
- 调查邻居SES与心脏病患者队列中所有原因和心脏病死亡率之间的关联.
主要方法:
- 在以色列中部 (1992-1993) 的1179名心脏病发作患者 (年龄<=65) 的队列一直被跟踪到2005年.
- 社区SES使用人口普查衍生的指数进行评估;收集个人SES数据 (教育,收入,就业).
- 使用生存率估计和调整后的危险比率分析了死亡率数据.
主要成果:
- 来自贫困地区的患者的死亡率更高 (13年生存率:61% vs 74% vs 82%).
- 经过多变量调整后,社区SES仍然是所有原因死亡率 (HR 1.47下与上三位数) 和心脏死亡率 (HR 1.63下与上三位数) 的重要预测指标.
- 社区环境和个人SES都与死亡率独立相关.
结论:
- 邻里SES是MI后长期生存的强有力的预测指标.
- 观察到的关联部分是由个体SES和临床因素解释的,但独立地持续存在.
- 这些发现凸显了SES和MI结果之间的复杂,多维关系.
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