探索社会经济地位和心肺运动测试措施之间的关联:基于例行收集数据的队列研究
Donna Shrestha1,2, Nicholas A Wisely3,4, Theodoros M Bampouras5
1Lancaster Medical School, Lancaster University, Lancaster, United Kingdom.
PloS one
|August 12, 2025
概括
来自贫困地区的患者心肺呼吸能力较低,正如心肺运动测试 (CPET) 所示. 这突显了手术候选人之间生理储备的社会经济差异,表明需要量身定制的术后护理.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心肺运动测试 (CPET) 对于评估心肺健康和手术风险至关重要.
- 社会经济地位 (SES) 显著影响患者的健康和结果.
- 了解CPET测量中的SES变化对于公平的外科护理至关重要.
研究的目的:
- 调查等待选择性手术的患者在社会经济贫困水平之间,CPET衍生的心肺呼吸能力测量如何不同.
- 确定影响手术患者生理储备的特定社会经济因素.
主要方法:
- 对3344名接受CPET (2011-2024) 的患者数据库的分析.
- 在社会经济贫困五分位数中比较CPET措施 (例如,峰值氧气消耗,气交换值).
- 用于评估SES,人口统计学和健康因素对CPET结果的影响的多变量和等级回归模型.
主要成果:
- 较低的SES与年轻的年龄,更高的BMI,更高的吸烟率和更高的修订心脏风险指数 (RCRI) 有关.
- 与最贫困的五分之一患者相比,最贫困的五分之一患者的峰值氧气消耗和气体交换值明显较低.
- 社会经济剥夺独立地预测了心肺呼吸能力的降低,社会决定因素解释了一些差异.
结论:
- 来自较贫困地区的个人表现出较差的心肺健康状况和增加的健康风险因素.
- 调查结果强调了手术患者在生理储备方面的重大社会经济差异.
- 结果支持在外科手术管理中需要全面,社会经济意识的方法.
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