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对于查检测到的老年人与现有的慢性病的结果:一个队列研究与数据链接
Anna K Forbes1, José M Ordóñez-Mena1,2, Winnie Mei1
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BJGP open
|September 19, 2024
概括
与常规诊断相比,对慢性病 (CKD) 的老年人进行查显示,死亡率,住院和心血管疾病 (CVD) 的风险与常规诊断相比相当. 这表明查可能是有价值的早期检测在这个人群中.
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:
- 慢性病 (CKD) 影响着全球大部分老年人,增加了心血管疾病 (CVD),末期病 (ESKD) 和死亡率的风险.
- 许多老年人患有CKD的病例仍未被诊断出来,这凸显了人们对查的好处的理解上的差距.
- 现有的研究对老年人群中CKD查的价值提供了有限的见解.
研究的目的:
- 为了比较预先存在CKD诊断的个体与通过查发现的个体之间的不良健康结果.
- 确定与诊断为CKD的患者死亡率相关的关键因素.
主要方法:
- 一项前性队列研究,涉及892名60岁及以上的初级保健患者,患有CKD (现有或查检测).
- 使用与民事死亡登记册和二级护理记录的数据链接.
- 考克斯比例危险模型用于估计各种结果的危险比率 (HRs) 和95%置信区间 (CI).
主要成果:
- 在3-5年的中位数随访期间,在现有CKD和查检测到的CKD组之间没有观察到组合不良结果的显著差异 (HR 0.94,95%CI = 0.67至1.33).
- 与死亡风险增加相关的因素包括年龄 (HR 1.10),男性性别 (HR 2.31) 和心力衰竭 (HR 5.18).
- 记录的关键结果包括全因死亡率 (49例死亡),住院病例 (512例) 和意外心血管疾病事件 (78例).
结论:
- 对老年人进行CKD查似乎是有价值的,因为确诊的个体面临的死亡,住院和心血管疾病的风险与常规诊断的人相比较.
- 需要进行进一步的大规模研究,并进行延长的随访.
- 研究应该集中在多样化和代表性的老年人群中,以证实这些发现.
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