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健康不平等和从儿科中风开始到到达的时间
Akshat M Pai1,2,3, Teresa To2,3,4, Gabrielle A deVeber1,2,3
1Division of Neurology (A.M.P., G.A.V., N.D.), The Hospital for Sick Children, Toronto, Canada.
Stroke
|March 15, 2024
概括
儿童中风病例在贫困社区增加,随着时间的推移,急诊室的到来更早. 需要进一步的研究来了解物质剥夺和中风发作到达时间之间的复杂关系.
科学领域:
- 儿科神经学 儿科神经学
- 公共卫生 公共卫生
- 健康 公平 研究 健康 公平 研究
背景情况:
- 脑卒中发作到达的时间对治疗和结果至关重要.
- 受到结构性,社会经济和环境因素影响的健康不平等,影响成人中风发作到达.
- 这项研究探讨了健康不平等对儿科中风发作到发作的影响.
研究的目的:
- 评估儿童中风患者的健康不平等和发作到到来时间之间的联系.
- 检查社区级物质剥夺作为健康不平等的代理者的作用.
- 分析与社会经济因素相关的儿科中风发病率和到达时间的趋势.
主要方法:
- 从2004年至2019年对患有急性动脉缺血性中风 (AIS) 的儿童 (28天-18岁) 的回顾性观察研究.
- 来自邮政编码的社区级物质剥夺作为健康不平等措施.
- 多变量顺序逻辑回归分析了剥夺和开始到达 (<6, 6-24, >24小时) 之间的关联,并调整了混因素.
主要成果:
- 总共有229名儿童被纳入调查;其中61%是男性,平均年龄为5.8岁.
- 越来越多的儿科AIS病例来自最贫困的社区,趋势是急诊室的提前到来 (<6小时,P=0.01).
- 亚洲患者在贫困社区 (P=0.02) 的患病率更高,物质贫困与AIS风险因素相关 (P=0.001).
结论:
- 儿童中风似乎在贫困社区增加,随着时间的推移,观察到更早的急诊室到来.
- 这些变化的原因 (增加发病率与提高认识/诊断) 需要进一步调查.
- AIS风险因素,物质剥夺和发病到到达之间的相互作用是复杂的,需要进行更深入的检查.
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