文章摘要
孙佳艺,高屾,赵冬,王淼,张倩,韩雪玉,刘静.北京市居民急性心肌梗死病例出院后30天再住院率及变化趋势[J].中华流行病学杂志,2020,41(6):866-871
北京市居民急性心肌梗死病例出院后30天再住院率及变化趋势
Trends regarding the 30-day readmission rates in patients discharged for acute myocardial infarction in Beijing
收稿日期:2019-06-24  出版日期:2020-06-16
DOI:10.3760/cma.j.cn112338-20190624-00460
中文关键词: 急性心肌梗死;住院;再住院率
英文关键词: Acute myocardial infarction;Hospitalization;Readmission
基金项目:首都卫生发展科研专项(2016-1-1051)
作者单位E-mail
孙佳艺 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029  
高屾 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029  
赵冬 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029  
王淼 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029  
张倩 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029  
韩雪玉 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029  
刘静 首都医科大学附属北京安贞医院 北京市心肺血管疾病研究所流行病研究室, 北京 100029 ejingliu@163.com 
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中文摘要:
      目的 分析2007-2012年北京市急性心肌梗死(AMI)出院病例30 d内因冠心病再住院率在不同人群中的特征及随时间的变化趋势。方法 从“北京市心血管病监测系统”中获取2007年1月1日至2012年12月31日主要出院诊断为AMI的病例,经过户籍地址整理、重报病例排查、数据完整性和准确性审核后,纳入≥25岁北京市户籍AMI出院存活病例64 355例。分析北京市AMI出院病例30 d内因冠心病再住院率的数据,采用泊松回归模型分析再住院率的变化趋势。结果 2007-2012年≥25岁北京市户籍AMI出院病例30 d内因冠心病再住院的年龄标化率为7.7%,调整年龄和性别后,再住院率随时间呈上升趋势(P<0.001),6年间从7.0%上升到8.5%,增加了21.3%。调整年龄后,女性AMI出院病例30 d再住院率(8.4%)高于男性(7.4%),6年间男、女性的30 d再住院率均呈增加趋势。非ST段抬高型心肌梗死出院病例的30 d再住院率高于ST段抬高型心肌梗死出院病例(P<0.01),有合并疾病病例的30 d再住院率高于没有合并疾病病例(P<0.01)。结论 2007-2012年北京市≥25岁户籍居民AMI出院病例30 d因冠心病再住院率呈持续增加趋势,应加强AMI出院病例的二级预防,特别是在女性病例、非ST段抬高型心肌梗死病例和合并多种疾病病例。
英文摘要:
      Objective To examine the characteristics and trends regarding the 30-day coronary heart disease (CHD) readmission rates in patients discharged for acute myocardial infarction (AMI) in Beijing, during 2007-2012. Methods Patients hospitalized for AMI in Beijing from 1 January 2007 to 31 December 2012 were identified from “The Cardiovascular Disease Surveillance System in Beijing”. In total, 64 355 patients aged 25 years and over with permanent Beijing residency survived and discharged for AMI in Beijing during the above-said six years. After excluding duplicate and validation for the completeness and accuracy of the records, clinical features and 30-day CHD readmission rates for those AMI discharged patients were analyzed. Trends regarding the 30-day CHD readmission rates in patients discharged for AMI were analyzed by Poisson regression models. Results The overall age-standardized average 30-day CHD readmission rate for AMI discharged patients was 7.7% in patients aged 25 years and over in Beijing. During the six years under study, an increasing trend was observed on the 30-day CHD readmission rates for AMI discharged patients after adjusting the age and gender (P<0.001). The age-standardized 30-day CHD readmission rates for AMI discharged patients increased by 21.3% in the past six years, from 7.0% in 2007 to 8.5% in 2012. The increase of 30-day CHD readmission rates was noted in both men and women during the six years, whereas it appeared higher in women (8.4%) than in men (7.4%), after adjusting for age. Among the AMI discharged patients, the 30-day CHD readmission rates were higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than those with ST-segment elevation myocardial infarction patients (P<0.01), and higher in discharged patients with multiple comorbidities than those without multiple comorbidities (P<0.01). Conclusions An increasing trend in the 30-day CHD readmission rates for AMI discharged patients was observed during 2007-2012 among Beijing residents aged 25 years and over. It called for an urgent need in improving the secondary prevention of AMI discharged patients, particularly in women, with NSTEMI and those with multiple comorbidities. Findings from these unselected “real-world” data in Beijing may help to guide the management of AMI in the country as well as in other developing countries.
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