秋明市25-64岁妇女心血管疾病10年总死亡风险评估算法(秋明风险量表)

G. Pushkarev, S. Matskeplishvili, V. Kuznetsov, E. Akimova
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摘要

目的:确定俄罗斯女性依赖传统和社会心理危险因素(RF)的10年心血管总死亡风险,并设计其估计算法。研究对象为秋明市中央行政区无组织人口。流行病学研究,基于1000名25-64岁女性的代表性选择。筛查应答率为81.3%。研究10年内心血管疾病死亡率。在随访10年的女性队列中,共登记了31例心血管死亡病例。我们使用多变量Cox回归模型来估计风险比(HR)和置信区间(CI)。分析死亡率与年龄、吸烟、受教育程度、职业、婚姻状况、收缩压和舒张压、体重指数、总胆固醇、低、高密度脂蛋白胆固醇等因素的关系。为了建立总心血管风险模型,我们选择了6个具有统计学意义的指标:年龄(HR - 1.099, 95% CI 1.032-1.1.69)、SBP (1.026, 95% CI 1.011-1.041)、小学教育程度(4.315,95% CI 1.878-9.910)、与重体力劳动相关的工作(4.073,95% CI 1.324-12.528)、高管(3.822,95% CI 1.384 -10.537)和婚姻状况(2.978,95% CI 1.197-7.409)。在此基础上设计的女性心血管总死亡风险模型具有较好的预测精度(AUC为0.882,95% CI为0.833 ~ 0.930)。因此,基于统计上显著的传统和社会心理RF建立的数学模型,可以有效地预测女性人群在个体水平上的心血管总风险。
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Algorithm for assessing the total 10 years risk of death from cardiovascular diseases in women 25-64 years old in Tyumen (Tyumen risk scale)
Purpose: To define total 10-year cardiovascular mortality risk in Russian females in dependence on traditional and psychosocial risk factors (RF) and to design the algorithm of its estimation.Methods. The study included non-organized population of Central Administrative district of Tyumen city. Epidemiological study, based on the representative selection of 1000 females aged 25-64 years. Screening respond was 81.3%. Cardiovascular mortality rate within 10 years was studied. Totally, 31 cases of cardiovascular death were registered in female cohort within 10year follow-up. We used a multivariate Cox regression model to estimate hazard ratio (HR) and confidence interval (CI). Relations between mortality rate and factors such as age, smoking, education, occupation, marital status, systolic and diastolic blood pressure (SBP and DBP), body mass index, total cholesterol, cholesterol of low and high density lipoproteins were analyzed.Results. To build a model of total cardiovascular risk, six statistically significant indicators were selected: age (HR – 1.099, 95% CI 1.032-1.1.69), SBP (1.026, 95% CI 1.011-1.041), primary education (4.315, 95% CI 1.878-9.910), work associated with heavy physical labor (4.073, 95% CI 1.324-12.528), executives (3.822, 95% CI 1.386-10.537) and marital status (2.978, 95% CI 1.197-7.409). Based on these data, model for total cardiovascular mortality risk in females was designed with good predictive accuracy (AUC was 0.882, 95% CI – 0.833 – 0.930).Conclusion. Thus, created mathematical model, built based on statistically significant traditional and psychosocial RF, makes it possible to effectively predict the total cardiovascular risk at the individual level in the female population.
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