Blackledge Hanna M, Newton James, Squire Iain B
Leicestershire Health Authority Department of Public Health Medicine.
BMJ. 2003 Sep 6;327(7414):526-31. doi: 10.1136/bmj.327.7414.526.
To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome.
Historical cohort study.
UK district health authority (population 960,000).
5789 consecutive patients newly admitted with heart failure.
Population admission rates, incidence rates for first admission with heart failure, survival, and readmission rates.
When compared with the white population, South Asian patients had significantly higher age adjusted admission rates (rate ratio 3.8 for men and 5.2 for women) and hospital incidence rates (2.2 and 2.9). Among 5789 incident cases of heart failure, South Asian patients were younger and more often male than white patients (70 (SD 0.6) v 78 (SD 0.1) years and 56.5% (190/336) v 49.3% (2494/5057)). South Asian patients were also more likely to have previous myocardial infarction (10.1% (n = 34) v 5.5% (n = 278)) or concomitant myocardial infarction (18.8% (n = 63) v 10.7% (n = 539)) or diabetes (45.8% (n = 154) v 16.2% (n = 817), all P < 0.001). A trend was shown to longer unadjusted survival for both sexes among South Asian patients. After adjustment for covariables, South Asian patients had a significantly lower risk of death (hazard ratio 0.82, 95% confidence interval 0.68 to 0.99) and a similar probability of death or readmission (0.96, 0.81 to 1.09) compared with white patients.
Population admission rates for heart failure are higher among South Asian patients than white patients in Leicestershire. At first admission South Asian patients were younger and more often had concomitant diabetes or acute ischaemic heart disease than white patients. Despite major differences in personal characteristics and risk factors between white and South Asian patients, outcome was similar, if not better, in South Asian patients.
比较新入院的心力衰竭白人患者和南亚患者的住院模式及预后，并评估个人特征和合并症对预后的影响。
历史性队列研究。
英国地区卫生当局（人口96万）。
5789例连续新入院的心力衰竭患者。
总体住院率、首次因心力衰竭入院的发病率、生存率和再入院率。
与白人相比，南亚患者年龄调整后的住院率（男性率比为3.8，女性为5.2）和医院发病率（分别为2.2和2.9）显著更高。在5789例心力衰竭病例中，南亚患者比白人患者更年轻，男性比例更高（分别为70（标准差0.6）岁对78（标准差0.1）岁，56.5%（190/336）对49.3%（2494/5057））。南亚患者既往心肌梗死（10.1%（n = 34）对5.5%（n = 278））、合并心肌梗死（18.8%（n = 63）对10.7%（n = 539））或糖尿病（45.8%（n = 154）对16.2%（n = 817））的可能性也更高（均P < 0.001）。南亚患者两性未经调整的生存期有延长趋势。在对协变量进行调整后，与白人患者相比，南亚患者死亡风险显著降低（风险比0.82，95%置信区间0.68至0.99），死亡或再入院概率相似（0.96，0.81至1.09）。
在莱斯特郡，南亚患者心力衰竭的总体住院率高于白人患者。首次入院时，南亚患者比白人患者更年轻，合并糖尿病或急性缺血性心脏病的情况更常见。尽管白人和南亚患者在个人特征和危险因素方面存在重大差异，但南亚患者的预后相似，甚至更好。
