Radisauskas Ricardas, Bernotiene Gailute, Rastenyte Daiva
Institute of Cardiology, Kaunas University of Medicine, Sukileliu 17, 3007 Kaunas, Lithuania.
Medicina (Kaunas). 2004;40(1):75-80.
The aim of the study was to evaluate trends in out-of-hospital mortality from ischemic heart disease (IHD) in Kaunas population aged 25-64 years during 1983-1998, according to the ischemic heart disease register data.
The primary source of data was Kaunas population-based ischemic heart disease register. The main sources of information for registration of ischemic heart disease events were hospital discharge records, patient follow-up records of out-of-patient departments, death certificates, necropsy and medico-legal records. The data were collected according to the requirements of the WHO program MONICA. Only deaths from IHD that occurred out-of-hospital were analyzed in this study. The age-standardized rates were calculated by the direct method and the world standard population was used as the standard. Trends in rates were analyzed using the method of linear regression on logarithms of the age-standardized annual mortality rates.
During 1983-1998, out-of-hospital IHD mortality was 137.9/100000 among Kaunas men aged 25-64 years meanwhile among women the corresponding rate was 7 times lower (20.2/100000). During 1983-1994, out-of-hospital mortality from IHD was increasing and during 1995 to 1998 was decreasing (by 19.8% per year; p=0.03) among men. Among women, out-of-hospital mortality rates were increasing during 1983-1990, were rather stable during 1991-1994, and tended to decrease by 27.5% per year (p=0.09) during 1995-1998. When analyzing trends in rates by 10-year age groups, statistically significant changes in out-of-hospital mortality from IHD were detected just among those aged 55-64 years. Among men, out-of-hospital mortality from IHD tended to increase during 1983-1994, and was decreasing statistically significantly (by 22.9% per year; p=0.007) during 1995-1998. Among women, the corresponding rates were increasing by 26.7% per year (p=0.03) during 1983-1986, and tended to decrease by 40.1% per year, (p=0.09) during 1995-1998. During 1983-1998, out-of-hospital deaths from IHD accounted on the average for 76.5% among all deaths from IHD among men and for 66.9% among women. During 1983-1998, the proportion of out-of-hospital deaths among all deaths from IHD remained without statistically significant changes among both men and women.
During 1983-1994, out-of-hospital mortality rates of Kaunas middle-aged men increased and during 1995-1998--significantly decreased. Out-of-hospital mortality rates of Kaunas women increased during 1983-1990, but in 1995-1998--tended to decline. Out-of-hospital deaths from IHD accounted on the average for 76.5% of all deaths from IHD among men and for 66.9% of women deaths, and biggest part of these deaths were among younger persons.
本研究旨在根据缺血性心脏病登记数据，评估1983 - 1998年考纳斯25 - 64岁人群中心脏性猝死的趋势。
数据的主要来源是考纳斯基于人群的缺血性心脏病登记处。缺血性心脏病事件登记的主要信息来源是医院出院记录、门诊部患者随访记录、死亡证明、尸检和法医学记录。数据根据世界卫生组织MONICA项目的要求收集。本研究仅分析院外发生的缺血性心脏病死亡情况。年龄标准化率采用直接法计算，并以世界标准人口作为标准。年龄标准化年死亡率对数的线性回归方法用于分析发病率趋势。
1983 - 1998年期间，考纳斯25 - 64岁男性院外缺血性心脏病死亡率为137.9/10万，而女性相应比率低7倍（20.2/10万）。1983 - 1994年期间，男性院外缺血性心脏病死亡率呈上升趋势，1995 - 1998年呈下降趋势（每年下降19.8%；p = 0.03）。女性中，1983 - 1990年院外死亡率呈上升趋势，1991 - 1994年相当稳定，1995 - 1998年呈每年下降27.5%的趋势（p = 0.09）。按10岁年龄组分析发病率趋势时，仅在55 - 64岁年龄组中发现院外缺血性心脏病死亡率有统计学显著变化。男性中，1983 - 1994年院外缺血性心脏病死亡率呈上升趋势，1995 - 1998年呈显著下降趋势（每年下降22.9%；p = 0.007）。女性中，1983 - 1986年相应比率每年上升26.7%（p = 0.03），1995 - 1998年呈每年下降40.1%的趋势（p = 0.09）。1983 - 1998年期间，男性院外缺血性心脏病死亡平均占所有缺血性心脏病死亡的76.5%，女性占66.9%。1983 - 1998年期间，男性和女性中，院外死亡占所有缺血性心脏病死亡的比例均无统计学显著变化。
1983 - 1994年期间，考纳斯中年男性院外死亡率上升，1995 - 1998年显著下降。考纳斯女性院外死亡率在1983 - 1990年上升，但在1995 - 1998年呈下降趋势。院外缺血性心脏病死亡平均占男性所有缺血性心脏病死亡的76.5%，女性死亡的66.9%，且这些死亡的最大部分发生在年轻人中。
