美国退伍军人在COVID-19大流行期间的过度死亡率:个体级别的队列研究
Daniel M Weinberger1,2, Krishnan Bhaskaran3, Caroline Korves4
1Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
International journal of epidemiology
|October 6, 2023
概括
个人层面的数据显示,美国退伍军人的COVID-19流行病过度死亡率模式显著. 虚弱和并发症在绝对和相对尺度上不同影响了结果,为未来的公共卫生反应提供了信息.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 大多数COVID-19过度死亡率分析使用汇总数据,限制了详细的理解.
- 来自美国退伍军人事务部 (VA) 医疗保健系统的个人级别数据提供了更深入的见解.
研究的目的:
- 利用个人级别数据分析COVID-19大流行期间的过度死亡率模式.
- 将人口统计和临床子组的绝对和相对尺度上的过度死亡率进行比较.
主要方法:
- 在2018年3月至2022年2月期间,对5,905,747名VA患者进行了观察性队列研究.
- 估计的过度死亡率,过度死亡人数和危险比率 (HR),比较大流行和大流行前的时期.
- 使用查尔森共发病指数和退伍军人衰老队列研究指数评估并发病负担和脆弱性.
主要成果:
- 整体过度死亡率为10.0例/1000人/年,共计103,164例过度死亡 (HR 1.25).
- 绝对过度死亡率最高的是最脆弱 (52.0/1000 PY) 和并发病率最高 (16.3/1000 PY) 的患者.
- 最大的相对死亡率增加在最不脆弱的人群 (HR 1.31) 和具有最低并发症的人群 (HR 1.44) 中观察到.
结论:
- 个人层面的数据为美国在COVID-19大流行期间的过度死亡率提供了关键的见解.
- 绝对与相对过度死亡率的差异凸显了细微报告的必要性.
- 调查结果强调为未来的公共卫生紧急情况量身定制的资源分配策略.
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