降低糖尿病并发症的国家趋势隐藏了区域差异:基于芬兰医疗保健登记的前性基于人口的研究
Klas Winell1,2, Martti Arffman1, Veikko Salomaa1
1THL - Finnish Institute of Health and Welfare, Helsinki, Finland.
Scandinavian cardiovascular journal : SCJ
|August 24, 2023
概括
芬兰糖尿病患者的心血管并发症在2010-2017年期间在全国范围内下降. 然而,这些结果的显著区域差异,特别是急性冠状动脉综合征,突出了需要改善糖尿病护理的领域.
科学领域:
- 公共卫生和流行病学
- 心血管医学 心血管医学
- 糖尿病研究研究 糖尿病研究
背景情况:
- 改善糖尿病患者的护理对于减少心血管并发症至关重要.
- 国家和地区数据分析对于了解护理改进的影响至关重要.
- 自1964年以来,芬兰就拥有全面的糖尿病患者登记册.
研究的目的:
- 评估增强的糖尿病护理是否反映在芬兰的国家和地区心血管并发症率上.
- 分析糖尿病患者急性冠状动脉综合征,缺血性中风和下肢截肢的趋势.
- 为了确定这些并发症率的区域差异.
主要方法:
- 从1964年起,利用了所有芬兰糖尿病患者的数据.
- 从2010年到2017年,检查了第一个急性冠状动脉综合征,缺血性中风和主要下肢截肢的发生率.
- 计算了年龄和性别标准化的发病率,并使用了波松回归模型来评估各大学和医院区的年度趋势和区域差异.
主要成果:
- 在糖尿病患者中,急性冠状动脉综合征 (2.7%),缺血性中风 (2.0%) 和主要下肢截肢 (4.6%) 的全国年均发病率下降.
- 在急性冠状动脉事件的减少方面,观察到性别之间存在显著差异,女性每年出现的急性冠状动脉事件减少幅度比男性 (2.1%) 大 (3.4%).
- 在并发症发生率和趋势方面发现了显著的区域差异,最显著的是大学医院区间的急性冠状动脉综合征.
结论:
- 2010年至2017年,芬兰糖尿病患者心血管事件的发生率在全国范围内继续下降.
- 在并发症率方面仍然存在显著的区域差异,这表明护理的有效性不均.
- 需要有针对性的干预措施来解决区域差异,并进一步改善糖尿病护理结果.
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