南沃罗和奥罗米亚特区公立医院高血压患者高血压危象和中风的决定因素

Belachew Tegegne, Debernesh Goshiye, Zemen Mengesha, Mekuriaw Wuhib
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Systematic random sampling technique was used to select study participants. Data were entered into Epidata version 3.1 and analyzed using Statistical package for social sciences version 23. Variables having P<0.25 in binary logistic regression was retained in the multivariable analysis to control the effect of confounding. Finally, determinants were identified based on adjusted odds ratio along with 95% confidence level at p-value less than 0.05. Model fitness was checked using Hosmer-Lemshow test. Results: In this study, the magnitude of hypertensive crisis was 35.6%(95%CI:31.1,40.4). Age(41-60years)(AOR=0.76,95%CI:0.42,0.98), Social support(AOR=0.82,95%CI:0.41,0.93), living in urban(AOR=0.56,95%CI:0.24,0.86) and good medication adherence(AOR=0.48,95%CI:0.29,0.83) were determinants of hypertensive crisis. Another, the magnitude of stroke was 5.0%(95%CI:3.1,7.8). 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引用次数: 0

摘要

背景:高血压不受控制可导致高血压危像,这是世界范围内一个重要的公共卫生问题。高血压住院并发症的发生率持续增长,并与死亡率和不良出院增加有关。高血压危象和脑卒中是由多种因素引起的;然而,在埃塞俄比亚,特别是在研究地区,缺乏确定高血压危机和中风决定因素的研究。目的:探讨2022年南沃罗区和奥罗米亚特区公立医院高血压患者高血压危象和脑卒中的影响因素。方法:采用基于机构的横断面调查方法,对南沃罗和奥罗米亚特区公立医院的416名参与者进行调查。采用系统随机抽样方法选择研究对象。数据输入Epidata 3.1版本,使用Statistical package for social sciences version 23进行分析。在多变量分析中保留二元逻辑回归中P<0.25的变量,以控制混杂的影响。最后,根据调整后的优势比和p值小于0.05的95%置信水平确定决定因素。采用Hosmer-Lemshow检验模型适应度。结果:本组患者高血压危重程度为35.6%(95%CI:31.1,40.4)。年龄(41-60岁)(AOR=0.76,95%CI:0.42,0.98)、社会支持(AOR=0.82,95%CI:0.41,0.93)、居住在城市(AOR=0.56,95%CI:0.24,0.86)和良好的药物依从性(AOR=0.48,95%CI:0.29,0.83)是高血压危重症的决定因素。另一方面,卒中程度为5.0%(95%CI:3.1,7.8)。农村居住(AOR=3.4,95%CI:1.23,9.44)、收缩压(AOR=9.6,95%CI:2.71,34.06)、卒中家族史(AOR=0.26,95%CI:0.07,0.79)是卒中的决定因素。结论与建议:高血压危象的严重程度较高,而卒中的严重程度相对较低。41 ~ 60岁城市居住、社会支持和药物依从性是高血压危重的决定因素,农村居住、收缩压和卒中家族史是卒中的决定因素。因此,医疗保健提供者应该筛查老年患者和有家族病史的患者。
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Determinants of hypertension crisis and stroke among hypertensive patients in South Wollo and Oromia special zones public hospitals
Background: Uncontrolled hypertension results in hypertension crisis, and it is an important public health concern around the world. The incidence of complicating hospitalizations with hypertension continues to grow and is associated with increased mortality and adverse discharge. Hypertension crisis and stroke are caused by numerous factors; however, there is a paucity of studies to identify determinants of hypertension crisis and stroke in Ethiopia, particularly the study area. Objective: To identify determinants of hypertension crisis and stroke among hypertensive patients in South Wollo zone and Oromia special zone public hospitals, 2022. Methods: An institution based cross-sectional study was conducted among 416 participants in South Wollo and Oromia special zones public hospitals. Systematic random sampling technique was used to select study participants. Data were entered into Epidata version 3.1 and analyzed using Statistical package for social sciences version 23. Variables having P<0.25 in binary logistic regression was retained in the multivariable analysis to control the effect of confounding. Finally, determinants were identified based on adjusted odds ratio along with 95% confidence level at p-value less than 0.05. Model fitness was checked using Hosmer-Lemshow test. Results: In this study, the magnitude of hypertensive crisis was 35.6%(95%CI:31.1,40.4). Age(41-60years)(AOR=0.76,95%CI:0.42,0.98), Social support(AOR=0.82,95%CI:0.41,0.93), living in urban(AOR=0.56,95%CI:0.24,0.86) and good medication adherence(AOR=0.48,95%CI:0.29,0.83) were determinants of hypertensive crisis. Another, the magnitude of stroke was 5.0%(95%CI:3.1,7.8). Rural residence (AOR=3.4,95%CI:1.23,9.44), Systolic blood pressure (AOR=9.6,95%CI:2.71,34.06), family history of stroke (AOR=0.26,95%CI:0.07,0.79) were determinants of stroke. Conclusion and recommendation: The magnitude of hypertensive crisis was high, whereas the magnitude of stroke was relatively low. Age 41-60 years, urban residence, having social support and good medication adherence were determinants of hypertensive crisis, while rural residence, systolic blood pressure and family history of stroke were determinants of stroke. Thus, health care providers should screen aged patients and patients with family history of stoke.
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