蛛网膜下腔出血发病率和病死率的人口统计学差异:新西兰一项为期 18 年的全国性研究

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-09-17 DOI:10.1016/j.lanwpc.2024.101199
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引用次数: 0

摘要

背景虽然各国蛛网膜下腔出血(SAH)的发病率和病死率不尽相同,但很少有国家报告全国范围内的发病率,尤其是多种族人群的发病率和病死率。我们评估了新西兰(NZ)全国范围内蛛网膜下腔出血(SAH)的发病率和病死率,并探讨了性别、地区、种族和时间上的差异。方法我们利用全国医院出院和死因收集的行政健康数据,确定了2001年至2018年期间新西兰的住院和致命的非住院动脉瘤性SAH。为了进行验证,我们将这些管理数据与两项前瞻性奥克兰地区社区卒中研究的数据进行了比较。随后,我们估算了SAH的发病率和病死率,并计算了调整后的比率比(RR)和95%置信区间,以评估亚人群之间的差异。研究结果在7818.75万累计人年中,我们发现了5371例SAH(95%的敏感性和85%的阳性预测值),全国范围内的年度年龄标准化发病率为8.2/10万。共有 2452 名(46%)患者在 SAH 后 30 天内死亡。与欧洲人/其他人相比,毛利人的发病率(RR = 2.23 (2.08-2.39))和病死率(RR = 1.14 (1.06-1.22))更高,而太平洋岛屿族裔的SAH发病率也更高(RR = 1.40 (1.24-1.59)),但亚洲人的发病率较低(RR = 0.79 (0.71-0.89))。按户籍地划分,年龄标准化SAH发病率介于6.3-11.5/100,000人年之间,病死率介于40%-57%之间。2001年至2018年期间,新西兰的SAH发病率下降了34%,病死率下降了12%。由于不同地区和种族群体的SAH发病率和病死率差异很大,因此在将重点地区的研究结果用于公共卫生规划时,尤其是在多种族人群中,应谨慎行事。
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Demographic disparities in the incidence and case fatality of subarachnoid haemorrhage: an 18-year nationwide study from New Zealand

Background

Although the incidence and case-fatality of subarachnoid haemorrhage (SAH) vary within countries, few countries have reported nationwide rates, especially for multi-ethnic populations. We assessed the nationwide incidence and case-fatality of SAH in New Zealand (NZ) and explored variations by sex, district, ethnicity and time.

Methods

We used administrative health data from the national hospital discharge and cause-of-death collections to identify hospitalised and fatal non-hospitalised aneurysmal SAHs in NZ between 2001 and 2018. For validation, we compared these administrative data to those of two prospective Auckland Regional Community Stroke Studies. We subsequently estimated the incidence and case-fatality of SAH and calculated adjusted rate ratios (RR) with 95% confidence intervals to assess differences between sub-populations.

Findings

Over 78,187,500 cumulative person-years, we identified 5371 SAHs (95% sensitivity and 85% positive predictive values) resulting in an annual age-standardised nationwide incidence of 8.2/100,000. In total, 2452 (46%) patients died within 30 days after SAH. Compared to European/others, Māori had greater incidence (RR = 2.23 (2.08–2.39)) and case-fatality (RR = 1.14 (1.06–1.22)), whereas SAH incidence was also greater in Pacific peoples (RR = 1.40 (1.24–1.59)) but lesser in Asians (RR = 0.79 (0.71–0.89)). By domicile, age-standardised SAH incidence varied between 6.3–11.5/100,000 person-years and case fatality between 40 and 57%. Between 2001 and 2018, the SAH incidence of NZ decreased by 34% and the case fatality by 12%.

Interpretation

Since the incidence and case-fatality of SAH varies considerably between regions and ethnic groups, caution is advised when generalising findings from focused geographical locations for public health planning, especially in multi-ethnic populations.

Funding

NZ Health Research Council.

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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