sociodemographic factors

社会人口因素
  • DOI:
    文章类型: Journal Article
    健康治疗和结果方面的社会人口不平等并不新鲜。然而,COVID-19大流行为检查和解决偏见提供了新的机会。本文介绍了在全球疫苗接种和治疗(2021年12月)开始之前发表的170篇论文的范围审查。我们报告了具有各种社会人口统计学特征的人与COVID-19相关的患者结局,包括需要插管和通气,重症监护室入院,出院接受临终关怀,和死亡率。使用PROGRESS-Plus框架,我们确定研究最多的社会人口因素是种族/民族/文化/语言。少数种族和族裔群体的成员往往有更糟糕的与COVID-19相关的患者预后;需要更多关于其他类别的社会劣势的研究,鉴于在审查时关于这些因素的文献很少。只有通过研究和解决社会劣势的原因,我们才能在未来的公共卫生危机中避免这种不公正。
    Socio-demographic inequities in health treatment and outcomes are not new. However, the COVID-19 pandemic presented new opportunities to examine and address biases. This article describes a scoping review of 170 papers published prior to the onset of global vaccinations and treatment (December 2021). We report differentiated COVID-19-related patient outcomes for people with various socio-demographic characteristics, including the need for intubation and ventilation, intensive care unit admission, discharge to hospice care, and mortality. Using the PROGRESS-Plus framework, we determined that the most researched socio-demographic factor was race/ethnicity/culture/language. Members of minoritized racial and ethnic groups tended to have worse COVID-19-related patient outcomes; more research is needed about other categories of social disadvantage, given the scarcity of literature on these factors at the time of the review. It is only by researching and addressing the causes of social disadvantage that we can avoid such injustice in future public health crises.
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  • 文章类型: Journal Article
    背景:双相情感障碍(BD)是一种以躁狂为特征的慢性复发性疾病,混合或抑郁发作,交替出现精神错乱的时期。几个预后因素与较高的复发率相关,这对于识别高风险个体至关重要。本研究旨在系统地回顾有关社会人口影响的现有文献,临床和环境因素,在临床复发中,由于BD的情绪发作而复发和住院。
    方法:对电子数据库的系统搜索(PubMed,进行Cochrane图书馆和WebofScience)以整合有关特定风险因素对这些结果的影响的当前证据。
    结果:58篇文章符合纳入标准。研究按评估的因素类型进行分组。家庭和个人精神病史,更严重的先前发作,发病年龄较早,快速循环的病史与临床复发有关,以及较低的全球功能和认知障碍。失业,受教育程度低,较差的社会适应和生活事件也与较高的发作频率有关,和大麻再次住院的可能性更高。
    结论:小样本量,缺乏随机临床试验,不同的随访期,对一些混杂因素缺乏控制,异质性研究设计和不同的临床结果。
    结论:尽管目前的证据仍有争议,有几个因素与预后受损有关,这可能使临床医生能够确定不良临床结局风险较高的患者,并找到可改变的因素。需要进一步的研究来阐明每个风险因素在上述结果中的影响。
    BACKGROUND: Bipolar disorder (BD) is a chronic and recurrent illness characterized by manic, mixed or depressive episodes, alternated with periods of euthymia. Several prognostic factors are associated with higher rates of relapse, which is crucial for the identification of high-risk individuals. This study aimed at systematically reviewing the existing literature regarding the impact of sociodemographic, clinical and environmental factors, in clinical relapses, recurrences and hospitalizations due to mood episodes in BD.
    METHODS: A systematic search of electronic databases (PubMed, Cochrane library and Web of Science) was conducted to integrate current evidence about the impact of specific risk factors in these outcomes.
    RESULTS: Fifty-eight articles met the inclusion criteria. Studies were grouped by the type of factors assessed. Family and personal psychiatric history, more severe previous episodes, earlier age of onset, and history of rapid cycling are associated with clinical relapses, along with lower global functioning and cognitive impairments. Unemployment, low educational status, poorer social adjustment and life events are also associated with higher frequency of episodes, and cannabis with a higher likelihood for rehospitalization.
    CONCLUSIONS: Small sample sizes, absence of randomized clinical trials, diverse follow-up periods, lack of control for some confounding factors, heterogeneous study designs and diverse clinical outcomes.
    CONCLUSIONS: Although current evidence remains controversial, several factors have been associated with an impaired prognosis, which might allow clinicians to identify patients at higher risk for adverse clinical outcomes and find modifiable factors. Further research is needed to elucidate the impact of each risk factor in the mentioned outcomes.
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  • 文章类型: Journal Article
    认知行为疗法已被确定为焦虑相关疾病的循证治疗。然而,支持这些治疗方法有效性的数据主要是从具有重要身份的参与者那里收集的,潜在地限制了他们可以被认为是“基于证据”的客户的程度。本综述研究了1993年至2023年美国焦虑相关疾病随机对照试验中的社会人口统计学代表和社会人口统计学报告质量。我们进行了一个系统的文献综述,以美国为基础的随机对照试验的认知行为疗法的焦虑相关障碍,提取社会人口统计学变量的数据,并对报告质量进行评级。来自55项符合条件的研究(N=4492)的数据表明,相对于美国人口,白人和女性身份的比例过高。有残疾状况等变量,性取向,和宗教认同一直被忽视。此外,报告质量普遍较差(平均值=10分之3.6),许多研究在分析或描述研究局限性时未能考虑人口统计学变量。出版年,样本量,NIH的资助状况并没有显著预测性别代表性(%女性),代表(%白色),或报告质量。这些发现强调了批判性评估“循证”治疗方法适用于谁以及增加临床样本多样性的重要性。以确保循证治疗具有包容性。对未来研究的建议,临床意义,并讨论了局限性。
    Cognitive behavioral therapies have been identified as evidence-based treatments for anxiety-related disorders. However, data supporting the effectiveness of these treatments have been largely collected from participants with majoritized identities, potentially limiting the extent to which they can be considered \"evidence-based\" for clients from minoritized groups. The current review examined sociodemographic representation and quality of sociodemographic reporting in randomized controlled trials for anxiety-related disorders in the U.S. between 1993 and 2023. We conducted a systematic literature review of U.S.-based randomized controlled trials of cognitive behavioral therapies for anxiety-related disorders, extracted data on sociodemographic variables, and rated quality of reporting. Data from 55 eligible studies (N = 4492) indicated that white and female identities were overrepresented relative to the U.S. population, with variables like disability status, sexual orientation, and religious identification consistently ignored. In addition, quality of reporting was generally poor (mean = 3.6 out of 10), with many studies failing to account for demographic variables in their analyses or description of study limitations. Publication year, sample size, and NIH funding status did not significantly predict gender representation (% women), ethnoracial representation (% white), or quality of reporting. These findings underscore the importance of critically evaluating to whom \"evidence-based\" treatments apply and increasing diversity of clinical samples, to ensure that evidence-based treatments are inclusive. Recommendations for future research, clinical implications, and limitations are discussed.
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  • 文章类型: Journal Article
    背景:许多经历心理健康并发症的人在尝试获得服务时面临障碍。为了弥合这种护理差距,数字心理健康创新(DMHI)已被证明是有价值的补充,通过增加获得护理的机会。评估DMHI的效用时要考虑的一个重要方面是可接受性。然而,目前尚不清楚不同的社会人口统计学群体对DMHI的感知接受度是否存在差异.
    目标:本范围审查旨在综合社会人口统计学因素的作用的证据(例如,年龄,性别)在寻求精神保健的个体中对DMHI的可接受性。
    方法:在JBI证据综合手册的指导下,关于范围审查的一章,根据PCC框架制定的搜索策略将在MEDLINE中实施,然后适用于四个电子数据库(即,CINAHL,MEDLINE,PsycINFO,和EMBASE)。研究选择策略将由两名审稿人对30篇文章的子集进行试验,直到审稿人之间的共识达到90%,之后,一名审稿人将完成剩余的标题和摘要筛选。全文筛选,数据提取策略,图表工具将由一名审阅者完成,然后由团队的另一名成员验证。主要调查结果将使用表格和数字显示。
    本范围审查将检查数字心理健康文献中考虑社会人口统计学因素的程度。此外,拟议的审查可能有助于确定在数字精神卫生保健背景下,某些人群的可接受性是否较低.这项调查旨在促进不同人群公平获得DMHI。
    BACKGROUND: Many individuals experiencing mental health complications face barriers when attempting to access services. To bridge this care gap, digital mental health innovations (DMHI) have proven to be valuable additions to in-person care by enhancing access to care. An important aspect to consider when evaluating the utility of DMHI is perceived acceptability. However, it is unclear whether diverse sociodemographic groups differ in their degree of perceived acceptability of DMHI.
    OBJECTIVE: This scoping review aims to synthesize evidence on the role of sociodemographic factors (e.g., age, gender) in the perceived acceptability of DMHI among individuals seeking mental health care.
    METHODS: Guided by the JBI Manual of Evidence Synthesis, chapter on Scoping Review, a search strategy developed according to the PCC framework will be implemented in MEDLINE and then adapted to four electronic databases (i.e., CINAHL, MEDLINE, PsycINFO, and EMBASE). The study selection strategy will be piloted by two reviewers on subsets of 30 articles until agreement among reviewers reaches 90%, after which one reviewer will complete the remaining screening of titles and abstracts. The full-text screening, data extraction strategy, and charting tool will be completed by one reviewer and then validated by a second member of the team. Main findings will be presented using tables and figures.
    UNASSIGNED: This scoping review will examine the extent to which sociodemographic factors have been considered in the digital mental health literature. Also, the proposed review may help determine whether certain populations have been associated with a lower level of acceptability within the context of digital mental health care. This investigation aims to favor equitable access to DMHI among diverse populations.
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  • 文章类型: Journal Article
    冠状病毒在全世界的眼前对全球经济造成了严重破坏。由于大流行期间不断变化的消费者需求和期望,各种商品和服务的供求与新冠肺炎前期不同。本文旨在了解购买和食物选择的变化,特别关注肉类和肉类产品,消费者和家庭为应对COVID-19大流行造成的危机而制作的。该研究还指出了这些变化的影响方向,并评估了影响它们的各种决定因素的贡献程度。2020年至2023年的文献综述是使用Scopus和WebofScience科学数据库进行的。该研究确定了社会人口统计学和个人因素是影响消费者购买或饮食行为的主要决定因素。正偏移(例如,实施策略,通过创建购物清单等活动来更好地管理家中的食物,消费者在参观商店期间的平均支出增长,并减少访问频率)或负面变化(例如,由于消费者的恐慌性购买,商店中的食品短缺,储存导致异常高的需求,购买更少的新鲜产品,增加不健康食品和零食的消费,在其他因素中)在隔离期间受到各种个体因素的影响(例如,动机,精神状态)或社会人口因素(例如,性别,年龄,收入水平,education).虽然在COVID-19大流行的早期阶段,个别因素对消费者行为的变化影响更大,随着大流行的进展,社会人口因素变得更加重要.
    The coronavirus has wreaked havoc on the global economy before the eyes of the entire world. Due to evolving consumer needs and expectations during the pandemic, the supply and demand for various goods and services varied from the pre-COVID-19 period. This article aims to understand the changes in purchasing and food choices, focusing particularly on meat and meat products, made by consumers and households in response to the crisis caused by the COVID-19 pandemic. The study also indicates the impact directions of these changes and assesses the magnitude of the contribution of various determinants that influenced them. The literature review from 2020 to 2023 was conducted using Scopus and the Web of Science scientific databases. The study identified sociodemographic and individual factors as the main determinants influencing consumers\' purchasing or eating behavior. Positive shifts (e.g., implementing strategies to better manage food at home through activities like creating shopping lists, the average increase in consumer spending during store visits, and decrease in visit frequencies) or negative changes (e.g., shortages of food products in stores due to consumer panic buying, unusually high demand resulting from stockpiling, purchasing fewer fresh products, increased consumption of unhealthy foods and snacking, among other factors) during isolation were influenced by various individual factors (e.g., motivation, mental state) or sociodemographic factors (e.g., gender, age, income level, education). While individual factors had a greater impact on changes in consumer behavior in the early stages of the COVID-19 pandemic, socio-demographic factors became more important as the pandemic progressed.
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  • 文章类型: Journal Article
    在印度,老年人的多重性发病率越来越令人担忧。多发病定义为个体中两种或多种慢性健康状况的共存。在印度,已经对多发病率的危险因素进行了初步研究,但是没有对这个主题进行系统的审查。本系统综述旨在综合印度老年人多发病危险因素的现有证据。
    遵循系统评价和荟萃分析指南的JBI和首选报告项目。直到2022年8月3日,搜索了几个数据库中已发表和未发表的研究。标题和摘要以及全文的筛选,数据提取,和质量评估由两名独立审核员进行。任何分歧都是通过讨论或让第三名审稿人参与解决的。数据综合采用叙事综合和随机效应荟萃分析,在适当的地方。
    从文献检索中确定的8781条记录中,系统评价和荟萃分析包括16和15项研究,分别。所有纳入的研究都是横断面的,10人的评估得分超过70%。广义上,社会人口统计学,生活方式,在这些研究中探讨了与健康状况相关的因素。与60-69岁相比,年龄≥70岁的人群多发病的合并几率更高(优势比(OR)1.51;95%置信区间(CI)1.20-1.91),女性与男性相比(1.38;1.09-1.75),单身,离婚,分离,与已婚相比,丧偶(1.29;1.11-1.49),与经济独立相比,经济上依赖(1.54;1.21-1.97),吸烟者与非吸烟者相比(1.33;1.16-1.52),并且与不工作相比,工作人数较低(0.51;0.36-0.72)。
    这项系统综述和荟萃分析通过综合印度老年人多症危险因素的现有证据,提供了该问题的全面图景。在制定针对印度老年人多发病的健康干预措施时,应考虑这些综合的社会人口统计学和生活方式因素。
    UNASSIGNED: Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India.
    UNASSIGNED: The JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta-analysis, where appropriate.
    UNASSIGNED: Out of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta-analysis, respectively. All included studies were cross-sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions-related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60-69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20-1.91), females compared to males (1.38; 1.09-1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11-1.49), economically dependent compared to economically independent (1.54; 1.21-1.97), and smokers compared to non-smokers (1.33; 1.16-1.52) and were lower in working compared to not working (0.51; 0.36-0.72).
    UNASSIGNED: This systematic review and meta-analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.
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  • 文章类型: Journal Article
    在临床试验中少数群体的代表性不足可能会阻碍肺康复(PR)计划对慢性阻塞性肺疾病(COPD)患者的潜在益处。这项工作的目的是确定在美国进行的PR随机对照试验(RCT)的参与者是否,加拿大,英国,澳大利亚是种族的代表,性别,性别,和社会人口特征。
    从成立到2022年12月对相关文献进行了系统搜索。在进行完整的文章审查之前,对标题和摘要进行了筛选。报告年龄的相关数据,性别,性别,种族,并提取参与者的社会人口统计学特征。
    三十六个RCT符合纳入标准。只有6%的出版物报道了种族,≥90%的参与者报告为“白色”。所有36篇论文都报道了年龄,平均年龄在60-69岁之间。35项研究报告了性别(97%),大多数(67%)报告男性多于女性参与者。在任何论文中都没有提到不同的性别。其他社会人口统计学因素在7篇(19%)论文中报道。
    临床试验中的包容性和代表性对于确保研究结果具有普遍性至关重要。临床试验师在招募期间需要考虑当今社会的人口统计学。
    UNASSIGNED: Underrepresentation of minority groups in clinical trials may hinder the potential benefits of pulmonary rehabilitation (PR) programs for individuals with chronic obstructive pulmonary disease (COPD). The aim of this work was to determine whether participants in PR randomized control trials (RCTs) conducted in the U.S.A., Canada, the UK, and Australia are representative of ethnicity, sex, gender, and sociodemographic characteristics.
    UNASSIGNED: A systematic search was performed for relevant literature from inception to December 2022. Titles and abstracts were screened before undergoing a full article review. Relevant data on reporting of age, sex, gender, ethnicity, and sociodemographic characteristics of participants was extracted.
    UNASSIGNED: Thirty-six RCTs met the inclusion criteria. Only 6% of publications reported on ethnicity, with ≥90% of participants reported as \'White.\' All 36 papers reported on age, with the mean between 60 and 69 years old. Thirty-five studies reported on sex (97%), with the majority (67%) reporting more male than female participants. There was no mention of different genders in any paper. Other sociodemographic factors were reported in 7 (19%) papers.
    UNASSIGNED: Inclusivity and representation in clinical trials are essential to ensure that research findings are generalizable. Clinical trialists need to consider the demographics of today\'s society during recruitment.
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  • 文章类型: Journal Article
    关于颞下颌关节紊乱病(TMD)发病率的文献通常报道了社会人口统计学因素,例如性别和年龄。然而,其他社会人口统计学因素在TMD中的作用和患病率尚不明确.因此,本范围综述旨在报告TMD患者中社会人口统计学因素的患病率.在PubMed和WebofScience数据库中进行了系统的搜索,以确定成人人群的临床试验,使用TMD研究诊断标准(RDC/TMD)或TMD诊断标准(DC/TMD),并报告TMD患者的社会人口统计学数据。27项符合标准的研究纳入本综述。纳入研究中评估的最常见的社会人口统计学因素是年龄,种族,教育,工作,收入,和婚姻状况。在纳入的研究中,观察到年轻和离婚个体的TMD患病率较高。然而,教育水平的结果相互矛盾,就业不被认为是TMD的危险因素。虽然这篇综述有方法论上的局限性,它表明TMD发病率与某些社会人口统计学因素之间存在关联;然而,需要进一步的研究来更确定这种关系。
    The literature on Temporomandibular Disorders (TMD) incidence commonly reports sociodemographic factors such as gender and age. However, the role and prevalence of other sociodemographic factors in TMD are not well defined. Therefore, this scoping review aimed to report the prevalence of sociodemographic factors in TMD patients. A systematic search was conducted in the PubMed and Web of Science databases to identify clinical trials in adult populations, using the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD) and reporting sociodemographic data in TMD patients. Twenty-seven studies meeting the criteria were included in this review. The most commonly reported sociodemographic factors assessed in the included studies were age, race, education, job, income, and marital status. TMD prevalence was observed to be higher among younger and divorced individuals among the included studies. However, conflicting results were found for education level, and employment was not considered a risk factor for TMD. Although this review has methodological limitations, it suggests an association between TMD incidence and certain sociodemographic factors; nevertheless, further studies are needed to establish this relationship more conclusively.
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  • 文章类型: Systematic Review
    简介:COVID-19大流行给医疗保健行业带来了前所未有的变化,包括通过远程医疗技术提供护理的大规模和快速转变。尽管远程医疗服务的扩展成功地继续为患者提供护理,同时防止疾病传播,尚不清楚患者的社会人口统计学特征在这段时间内如何影响远程医疗的使用。本研究旨在系统地回顾已发表的关于远程医疗接入人口统计学差异的文献,利用率,以及美国各种成年患者类型的健康结果。方法:Litcovid,PubMed,WebofScience,搜索了MEDLINE数据库,最终得到n=32项研究的样本。结果:结果发现,研究可以归类为针对八个不同调查领域中的至少一个:远程医疗使用的社会人口统计学差异(1)在大流行期间和(2)之前,远程医疗使用与不使用(3)在大流行期间和(4)之前,(5)远程医疗模式,(6)对远程医疗的满意度,(7)与远程医疗使用相关的结果,(8)感知或实际获得远程医疗服务。讨论:关于种族的纳入研究的结果是稳健的,年龄,以及远程医疗利用和健康结果的社会经济差异,反映了卫生保健获得方面的社会人口统计学差异,利用率,尽管由于COVID-19而扩大了远程医疗服务,但更广泛的结果仍然存在。总结了整个研究的其他发现,并讨论了未来研究的领域。
    Introduction: The COVID-19 pandemic brought unprecedented change to the health care industry, including a large and rapid shift to providing care through telehealth technologies. Although the expansion of telehealth services was successful in continuing to provide patients with care while preventing the spread of disease, it is less clear how patient sociodemographic characteristics influenced telehealth use during this time. This study aims to systematically review the published literature on demographic differences in telehealth access, utilization, and health outcomes among a variety of adult patient types in the United States. Methods: Litcovid, PubMed, Web of Science, and MEDLINE databases were searched, resulting in a final sample of n = 32 studies. Results: Results found that studies could be categorized as addressing at least one of eight different areas of inquiry: sociodemographic differences in telehealth use (1) during and (2) before the pandemic, telehealth use versus nonuse (3) during and (4) before the pandemic, (5) telehealth modality, (6) satisfaction with telehealth, (7) outcomes associated with telehealth use, and (8) perceived or actual access to telehealth services. Discussion: Findings are robust across included studies with respect to racial, age, and socioeconomic differences in telehealth utilization and health outcomes, reflecting sociodemographic differences in health care access, utilization, and outcomes more broadly that persist despite this expansion of telehealth services owing to COVID-19. Additional findings across studies are summarized and areas for future research are discussed.
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  • 文章类型: Meta-Analysis
    目的:确定与PAD患者下肢严重截肢相关的社会人口统计学因素的差异。
    方法:对文献进行系统综述,以确定报告不同社会人口统计学群体中PAD患者下肢严重截肢率的研究。根据性别比较截肢率的数据,种族,种族,收入,保险,地理,收集并描述医院类型。然后对结果进行汇总和标准化,进行荟萃分析,将数据合成为单一比值比.
    结果:41项研究纳入综述。在男性和女性之间没有发现相关性(OR:0.95,95%CI:0.90-1.00)。与白人相比,在黑人/非裔美国人(OR:2.02,95%CI:1.81-2.26)和美洲原住民(OR:1.22,95%CI:1.04-1.45)中截肢率较高.在白人和亚洲人之间没有发现显著的关联,夏威夷原住民,或太平洋岛民(OR:1.15,95%CI:1.00-1.33)。西班牙裔患者截肢率高于非西班牙裔患者(OR:1.36,95%CI:1.22-1.52)。与私人保险相比,在医疗保险中截肢率较高(OR:1.38,95%CI:1.27-1.50),医疗补助(OR:1.59,95%CI:1.44-1.76),和未投保者(OR:1.41,95%CI:1.02-1.95)。与收入最高的四分位数相比,第二收入四分位数的截肢率较高(OR:1.10,95%CI:1.05-1.15),第三收入四分位数(OR:1.20,95%CI:1.07-1.35),和最低收入四分位数(OR:1.36,95%CI:1.24-1.49)。在农村和城市人口之间(OR:1.35,95%CI:0.92-1.97)或教学医院与非教学医院之间(OR:1.01,95%CI:0.91-1.12)没有发现关联。
    结论:我们的研究发现了一些差异,并量化了社会人口统计学因素对由于PAD引起的主要下肢截肢率的影响。我们相信这些发现可用于更好地针对旨在降低截肢率的干预措施;尽管,需要进一步的研究来更好地理解我们发现背后的机制.
    OBJECTIVE: To identify disparities in sociodemographic factors that are associated with major lower limb amputation in patients with peripheral arterial disease (PAD).
    METHODS: A systematic review of the literature was performed to identify studies that reported major lower limb amputation rates in patients with PAD among different sociodemographic groups. Data that compared amputation rates on the basis of sex, race, ethnicity, income, insurance, geography, and hospital type were collected and described. Outcomes were then aggregated and standardized, and a meta-analysis was performed to synthesis data into single odds ratios (ORs).
    RESULTS: Forty-one studies were included in the review. There was no association found between males and females (OR, 0.95; 95% confidence interval [CI], 0.90-1.00). Compared with Whites, higher rates of amputation were seen among Blacks/African Americans (OR, 2.02; 95% CI, 1.81-2.26) and Native Americans (OR, 1.22; 95% CI, 1.04-1.45). No significant association was found between Whites and Asians, Native Hawaiians, or Pacific Islanders (OR, 1.15; 95% CI, 1.00-1.33). Hispanics had higher rates of amputation compared with non-Hispanics (OR, 1.36; 95% CI, 1.22-1.52). Compared with private insurance, higher rates of amputation were seen among Medicare patients (OR, 1.38; 95% CI, 1.27-1.50), Medicaid patients (OR, 1.59; 95% CI, 1.44-1.76), and noninsured patients (OR, 1.41; 95% CI, 1.02-1.95). Compared with the richest income quartile, higher rates of amputation were seen among the second income quartile (OR, 1.10; 95% CI, 1.05-1.15), third income quartile (OR, 1.20; 95% CI, 1.07-1.35), and bottom income quartile (OR, 1.36; 95% CI, 1.24-1.49). There was no association found between rural and urban populations (OR, 1.35; 95% CI, 0.92-1.97) or between teaching and nonteaching hospitals (OR, 1.01; 95% CI, 0.91-1.12).
    CONCLUSIONS: Our study has identified a number of disparities and quantified the influence of sociodemographic factors on major lower limb amputation rates owing to PAD between groups. We believe these findings can be used to better target interventions aimed at decreasing amputation rates, although further research is needed to better understand the mechanisms behind our findings.
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