Abstract:
Knowing the prevalence of potentially avoidable hospitalizations (PAHs) and the factors associated with them is essential if preventive action is to be taken. Studies on PAHs mainly concern adults, and very few have been carried out in South America. To the best of our knowledge, there has been no study on PAHs in French Guiana, particularly among older adults. This case-control study aimed to estimate the prevalence of PAHs in the Guianese population aged over 65 and to analyze their associated factors. We used the 2017-2019 data from the French National Health Service database (Système National des Données de Santé). The patients were age- and sex-matched 1 : 3 with controls without any PAH in 2019. Factors associated with PAHs were investigated through two conditional logistic regression models [one including the Charlson comorbidity index (CCI) and one including each comorbidity of the CCI], with calculation of the adjusted odds ratio (aOR) and 95% confidence interval (CI). The PAH incidence was 17.4 per 1000 inhabitants. PAHs represented 6.6% of all hospitalizations (45.6% related to congestive heart failure or hypertension). A higher CCI was associated with PAHs [aOR 2.2 (95% CI: 1.6, 3.0) and aOR 4.8 (95% CI: 2.4, 9.9) for 1-2 and ≥3 comorbidities, respectively, versus 0], as was immigrant health insurance status [aOR 2.3 (95% CI: 1.3, 4.2)]. Connective tissue disease, chronic pulmonary disease, congestive heart failure, diabetes, and peripheral vascular disease were comorbidities associated with an increased risk of PAHs. While the prevention of PAHs among immigrants is probably beyond the reach of the Guianese authorities, primary care and a public health policy geared toward prevention should be put in place for the French Guianese population suffering from cardiovascular disease in order to reduce PAHs.
摘要:
背景:如果要采取预防措施,了解潜在可避免的住院(PAH)的患病率及其相关因素至关重要。对PAH的研究主要涉及成年人,很少有人在南美进行。据我们所知,法属圭亚那还没有对PAH的研究,尤其是在老年人中。本病例对照研究旨在评估65岁以上圭亚那人群PAH的患病率并分析其相关因素。
方法:我们使用了法国国家卫生服务数据库中的2017-2019年数据(SystèmeNationaldesDonnéesdeSanté,SNDS)。2019年,患者的年龄和性别匹配为1:3,对照组没有任何PAH。通过两个条件逻辑回归模型(一个包括Charlson合并症指数(CCI),另一个包括CCI的每种合并症)调查了与PAH相关的因素。计算调整比值比(AOR)和95%置信区间(CI)。
结果:PAH发病率为17.4/1000居民。PAH占所有住院治疗的6.6%(45.6%与充血性心力衰竭或高血压有关)。较高的CCI与1-2和≥3合并症的PAH(aOR2.2(95CI:1.6,3.0))和aOR4.8(95CI:2.4,9.9)相关。分别,相对于0),移民健康保险状况也是如此(aOR2.3(95CI:1.3,4.2))。结缔组织病,慢性肺病,充血性心力衰竭,糖尿病和外周血管疾病是与PAH风险增加相关的合并症.
结论:虽然在移民中预防PAH可能超出了圭亚那当局的能力范围,应为患有心血管疾病的法属圭亚那人制定初级保健和旨在预防的公共卫生政策,以减少PAH。