县级的粮食不安全与心脏手术后的结果有关
Lovette Azap1, Selam Woldesenbet2, Hannah Osae2
1Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Center, United States; Division of Cardiothoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
American journal of surgery
|August 28, 2024
概括
粮食不安全 (FI) 与心脏手术结果较差有关. 高FI地区的患者的"教科书结果"更差,90天和5年死亡率增加,住院时间更长,突出了严重的公共卫生问题.
科学领域:
- 心血管外科心血管外科
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 关于粮食不安全 (FI) 对外科手术结果的影响的研究有限.
- 了解像FI这样的社会经济因素与患者结果之间的关联对于改善护理至关重要.
研究的目的:
- 调查县级粮食不安全 (FI) 与心脏手术后的结果之间的关系.
- 评估高水平的FI是否与不良的术后结果和生存率相关.
主要方法:
- 使用Medicare数据对267,914名接受冠状动脉旁路移植 (2016-2020) 的患者进行了回顾性队列研究.
- 根据县级数据,患者分为低,中等和高粮食不安全 (FI) 队列.
- 统计分析包括后勤和考克斯回归来评估"教科书结果",死亡率和生存率.
主要成果:
- 高FI区域的患者不太可能达到"教科书结果" (OR:0.94,95%CI:0.90-0.99).
- 高FI与90天死亡率 (OR:1.24,95%CI:1.12-1.36),延长停留时间 (OR:1.07,95%CI:1.01-1.14) 和5年死亡率 (HR:1.11,95%CI:1.06-1.17) 的增加有关.
- 观察到种族差异,高FI县的黑人患者与白人患者相比,面临更高的5年死亡风险.
结论:
- 县级的粮食不安全 (FI) 与心脏手术后更糟糕的结果显著相关.
- 解决粮食不安全问题可能是改善患者结果和减少心血管外科手术中的健康差异的重要策略.
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