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不稳定的住房和美国退伍军人接受透析的死亡率
Tessa K Novick1, Michael J Mader2, Kirsten L Johansen3
1University of Texas at Austin Dell Medical School, Austin.
JAMA network open
|November 21, 2023
概括
透析前不稳定的住房增加了美国退伍军人,特别是老年人的死亡风险. 需要进一步的研究来解决这一关键的健康决定因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 老年病的医生 老年病的医生
背景情况:
- 住房状况是健康结果的重要决定因素.
- 对于在透析患者中不稳定住房的流行和影响知之甚少.
- 了解这些因素对于改善患者护理和治疗结果至关重要.
研究的目的:
- 在接受透析的美国退伍军人中确定与不稳定的住房相关的因素.
- 估计不稳定的住房对该人口死亡风险的影响.
主要方法:
- 使用美国退伍军人健康管理局和美国脏数据系统的数据进行了回顾性队列研究.
- 纳入标准:2012年10月1日至2018年12月31日期间开始透析的退伍军人,VHA门诊使用和先前不稳定的住房查.
- 分析涉及多变量 Fine 和 Gray 累积发病率模型,以评估死亡风险,年龄作为影响修饰因素.
主要成果:
- 总共有25,689名退伍军人被纳入;3%的查结果为不稳定的住房呈阳性.
- 不稳定的住房与年轻的年龄,黑人和西班牙裔种族,中央静脉导管使用,中心血液透析和非医疗保险有关.
- 住房不稳定的退伍军人面临更高的全因死亡率 (AHR,1.20),随着年龄的增长,风险显著增加,特别是在75-85岁的人群中 (AHR,1.64).
结论:
- 在透析开始前不稳定的住房与美国退伍军人全因死亡风险增加有关.
- 不稳定的住房和死亡风险之间的关联在老年退伍军人中得到了放大.
- 需要进一步的研究,以了解老年人与不稳定的住房的经验,以及其在所有透析患者的流行情况.
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