患有风湿性心脏病的成年人死亡率和发病率
Ganesan Karthikeyan1,2, Mpiko Ntsekhe3, Shofiqul Islam4
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
JAMA
|June 5, 2024
概括
风湿性心脏病的死亡率很高,特别是在低收入国家. 门手术和门整形显著降低RHD死亡率,强调需要改善这些干预措施的可用性.
科学领域:
- 心脏病学
- 公共卫生
- 流行病学
背景情况:
- 风湿性心脏病 (RHD) 是低收入和中等收入国家 (LMICs) 的重大公共卫生问题.
- 涉及多个特有国家的大规模研究很少.
研究的目的:
- 确定RHD患者的主要临床结果的风险和预测因素.
- 分析世界银行不同国家收入群体的事件率.
主要方法:
- 一个多中心的前性观察研究,涉及24个RHD本土LMIC的138个地点.
- 在2016年8月至2022年5月期间注册了13,696名患者.
- 分析所有原因死亡率,特定原因死亡率,心力衰竭住院,中风,复发性类风湿性发烧和传染性内心炎.
主要成果:
- 平均随访时间为3. 2年,总死亡率为15%,主要是心力衰竭是主要的死亡原因.
- 严重的膜疾病标志物如心力衰竭和肺高血压增加了死亡率,而膜手术和膜整形术与死亡率显著降低有关.
- 在调整为患者水平因素后,较高的国家收入水平与较低的死亡率相关.
结论:
- 在RHD中,高死亡率与门疾病的严重程度有关.
- 获得门外科手术和门整形手术对于降低RHD相关死亡率至关重要.
- 调查结果强调,除了现有的预防措施外,还需要加强对外科手术和干预治疗的准入.
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