多发病模式、社会人口特征和死亡率:来自低资源环境的数据科学见解。

IF 5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH American journal of epidemiology Pub Date : 2024-12-19 DOI:10.1093/aje/kwae466
Juan Carlos Bazo-Alvarez, Darwin Del Castillo, Luis Piza, Antonio Bernabé-Ortiz, Rodrigo M Carrillo-Larco, Liam Smeeth, Robert H Gilman, William Checkley, J Jaime Miranda
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引用次数: 0

摘要

多病数据通常是通过统计疾病数量来分析的,这忽略了疾病之间的微妙关系。我们确定了具有不同风险的多病群和亚群,并使用数据驱动的方法检查了它们与全因死亡率的关系。我们分析了来自秘鲁的CRONICAS队列研究(一个多站点队列研究)中≥35岁人群的8年随访数据。首先,我们使用围绕介质的分区和多维尺度来识别多病态集群。然后我们估计了多病聚集性和全因死亡率之间的关系。其次,我们使用有限混合模型确定亚种群。我们的分析揭示了三种慢性疾病:呼吸系统(第一类:支气管炎、慢性阻塞性肺病和哮喘)、生活方式、高血压、抑郁症和糖尿病(第二类),以及循环系统(第三类:心脏病、中风和外周动脉疾病)。虽然只有包含循环系统疾病的集群显示出与总体人群中全因死亡率的显著关联,但我们确定了两个潜在的亚群(命名为I和II),它们与特定的多病集群相关,表现出不同的死亡率风险。这些发现强调了在了解死亡风险时考虑多发病群和社会人口学特征的重要性。它们还强调需要采取有针对性的干预措施,以满足患有多种疾病的不同亚人群的独特需求,从而有效降低死亡风险。
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Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings.

Multimorbidity data is typically analysed by tallying disease counts, which overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analysed 8-year follow-up data of people ≥35 years who were part of the CRONICAS Cohort Study, a multisite cohort from Peru. First, we used Partitioning Around Medoids and multidimensional scaling to identify multimorbidity clusters. We then estimated the association between multimorbidity clusters and all-cause mortality. Second, we identified subpopulations using finite mixture modelling. Our analysis revealed three clusters of chronic conditions: respiratory (cluster 1: bronchitis, COPD and asthma), lifestyle, hypertension, depression and diabetes (cluster 2), and circulatory (cluster 3: heart disease, stroke and peripheral artery disease). While only the cluster comprising circulatory diseases showed a significant association with all-cause mortality in the overall population, we identified two latent subpopulations (named I and II) exhibiting differential mortality risks associated with specific multimorbidity clusters. These findings underscore the importance of considering multimorbidity clusters and sociodemographic characteristics in understanding mortality risks. They also highlight the need for tailored interventions to address the unique needs of different subpopulations living with multimorbidity to reduce mortality risks effectively.

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来源期刊
American journal of epidemiology
American journal of epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.40
自引率
4.00%
发文量
221
审稿时长
3-6 weeks
期刊介绍: The American Journal of Epidemiology is the oldest and one of the premier epidemiologic journals devoted to the publication of empirical research findings, opinion pieces, and methodological developments in the field of epidemiologic research. It is a peer-reviewed journal aimed at both fellow epidemiologists and those who use epidemiologic data, including public health workers and clinicians.
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