巴西巴拉那州缺血性心脏病住院和死亡率的贝叶斯模型和空间风险估算。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI:10.5334/gh.1347

Amanda de Carvalho Dutra, Lincoln Luis Silva, Amanda Gubert Alves Dos Santos, Rogério do Lago Franco, Giane Aparecida Chaves Forato, Marcela Bergamini, Isadora Martins Borba, Edvaldo Vieira de Campos, Catherine Ann Staton, Diogo Pinetti Marquezoni, Oscar Kenji Nihei, João Ricardo Nickenig Vissoci, Luciano de Andrade

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引用次数: 0

摘要

目的：尽管在了解风险因素和治疗策略方面取得了重大进展，但缺血性心脏病（IHD）仍然是导致全球死亡的主要原因，尤其是在巴西的特定地区，该疾病更是一种负担。因此，本研究旨在估算巴西巴拉那州因缺血性心脏病住院和死亡的风险，并根据社会经济、人口和健康变量，利用空间分析确定风险较高的地区：这是一项生态学研究，基于 2010-2021 年期间从巴西住院和死亡率信息系统获得的二次和回顾性心肌梗死住院和死亡率数据。研究分析了巴拉那州 399 个城市和 22 个卫生区的数据。为了评估该疾病的空间模式并确定相对风险（RR）区域，我们使用 R 软件中的 R-INLA 和 SpatialEpi 软件包，通过贝叶斯推理建立了一个风险模型：在分析期间，共有 333,229 人住院，73,221 人死亡，小城市因心肌梗死住院（RR = 27.412，CI 21.801; 34.466）和死亡（RR = 15.673，CI 2.148; 114.319）的相对风险较高。此外，中型城市的心肌梗死住院率（RR = 6.533，CI 1.748; 2.006）和死亡率（RR = 6.092，CI 1.451; 2.163）也较高。40-59 岁的白人男性住院率和死亡率更高。市政绩效指数（IPDM）与心肌梗死住院率和死亡率之间呈负相关：结论：在巴西巴拉那州的中小城市中，发现了因急性心肌梗死住院和死亡风险增加的地区。这些结果表明，在这些地区，由于医疗资源分配不均，对心肌缺血病例的医疗关注不足。

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Bayesian Modeling and Estimation of Spatial Risk for Hospitalization and Mortality from Ischemic Heart Disease in Paraná, Brazil.

Objective: Despite significant advancements in understanding risk factors and treatment strategies, ischemic heart disease (IHD) remains the leading cause of mortality worldwide, particularly within specific regions in Brazil, where the disease is a burden. Therefore, the aim of this study was to estimate the risk of hospitalization and mortality from IHD in the state of Paraná (Brazil), using spatial analysis to identify areas with higher risk based on socioeconomic, demographic and health variables.

Methods: This is an ecological study based on secondary and retrospective IHD hospitalization and mortality data obtained from the Brazilian Hospitalization and Mortality Information Systems during the 2010-2021 period. Data were analyzed for 399 municipalities and 22 health regions in the state of Paraná. To assess the spatial patterns of the disease and identify relative risk (RR) areas, we constructed a risk model by Bayesian inference using the R-INLA and SpatialEpi packages in R software.

Results: A total of 333,229 hospitalizations and 73,221 deaths occurred in the analyzed period, and elevated RR of hospitalization (RR = 27.412, CI 21.801; 34.466) and mortality (RR = 15.673, CI 2.148; 114.319) from IHD occurred in small-sized municipalities. In addition, medium-sized municipalities also presented elevated RR of hospitalization (RR = 6.533, CI 1.748; 2.006) and mortality (RR = 6.092, CI 1.451; 2.163) from IHD. Hospitalization and mortality rates were higher in white men aged 40-59 years. A negative association was found between Municipal Performance Index (IPDM) and IHD hospitalization and mortality.

Conclusion: Areas with increased risk of hospitalization and mortality from IHD were found in small and medium-sized municipalities in the state of Paraná, Brazil. These results suggest a deficit in health care attention for IHD cases in these areas, potentially due to a low distribution of health care resources.

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.