社会经济贫困与出现腹腔大动脉动脉瘤破裂之间的关联
Victoria S Wu1, Francis J Caputo2, Jon G Quatromoni2
1Case Western Reserve University School of Medicine, Cleveland, OH.
Journal of vascular surgery
|September 1, 2023
概括
社会经济贫困和农村生活增加了腹部大动脉动脉瘤破裂 (rAAA) 的风险. 贫困地区65岁以下的个人面临更高的rAAA几率,突出了针对性查的必要性.
科学领域:
- 这是血管外科手术.
- 公共卫生 公共卫生
- 健康差异 在健康方面的差异.
背景情况:
- 腹腔大动脉动脉瘤 (AAA) 是死亡的一个重要原因.
- 美国预防服务工作组 (USPSTF) 的查指南旨在早期检测AAA.
- 健康的社会决定因素,包括社会经济地位和地理位置,可能会影响AAA呈现和结果.
研究的目的:
- 调查社会经济贫困,农村生活和美国腹部大动脉动脉瘤破裂 (rAAA) 的出现之间的联系.
- 根据社会决定因素,识别具有较高rAAA风险的特定人群.
- 为AAA检测提供有针对性的查策略的信息.
主要方法:
- 对患有AAA的患者进行血管质量倡议注册 (2010-2019) 的分析.
- 使用面积贫困指数 (ADI) 来量化社会经济地位,分成五分之一.
- 使用多变量逻辑回归来评估ADI,农村和rAAA呈现之间的关系,按年龄分层 (65岁).
主要成果:
- 较高的社会经济贫困 (最贫困的五分之一) 与增加rAAA呈现的几率有显著的相关性 (OR, 1.46).
- 与城市居民相比,农村居民的rAAA呈现率下降 (OR,0.84).
- 在65岁以下的患者中,社会经济贫困仍然与增加的rAAA几率有关 (OR,1.31),但农村地区没有显示出明显的关联.
结论:
- 在社会经济上贫困或农村地区的患者更有可能出现rAAA.
- 对于65岁以下的人来说,社会经济贫困是与增加rAAA呈现相关的关键因素.
- 了解这些社会决定因素对于开发有效的,早期的AAA查计划对有风险的人群至关重要.
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