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严重喘患者严重恶化率的国际变化
Tae Yoon Lee1, David Price2, Chandra Prakash Yadav3
1Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Canada.
Chest
|February 23, 2024
概括
严重喘恶化率在各国之间有很大差异,即使考虑到患者因素. 这凸显了对特定司法管辖区的风险预测和量身定制的疾病管理策略的需求.
科学领域:
- 肺部病理学 肺部病理学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 恶化频率是严重喘管理中治疗决策的关键决定因素.
- 了解恶化率的国际变化对于有效的全球疾病控制至关重要.
研究的目的:
- 量化不同国家的严重喘恶化率的变化程度.
- 探索这种变异性对喘疾病管理和治疗策略的影响.
主要方法:
- 分析了来自国际严重喘登记 (ISAR) 队列的生物原始严重喘患者 (≥18岁) 的数据.
- 严重的恶化被定义为口服皮质类固醇使用 (≥3天) 或与喘相关的住院/ED访问.
- 使用负二项式模型估计了特定国家的恶化率,并根据患者和疾病特征进行了调整.
主要成果:
- 该研究包括来自17个国家的7510名患者,其中56%来自美国.
- 观察到的严重恶化率在各国之间存在显著差异 (IQR:0.13-0.54),从阿根廷的0.04到沙特阿拉伯的0.88不等.
- 即使调整了患者特征和采样变化 (IQR:0.16-0.39) 后,这种变化仍然存在.
结论:
- 各国之间存在严重喘恶化风险的显著差异,即使在具有相似特征的患者中也是如此.
- 这些差异表明未测量的患者层面因素或医疗保健提供系统变化的影响.
- 疾病管理指南和风险预测模型需要司法校准以优化严重喘治疗.
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