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[2003年至2007年在弗洛里亚诺波利斯,加入家庭健康战略的时间对老年人预防心血管和脑血管意外的作用]

[Time of adhesion to the Family Health Strategy protects elderly against cardiovascular and cerebrovascular accidents in Florianópolis, 2003 to 2007].

作者信息

Xavier André Junqueira, dos Reis Sandro Sedrez, Paulo Elizabeth Machado, d'Orsi Eleonora

机构信息

Departamento de Medicina, Universidade do Sul de Santa Catarina, Tubarão, SC.

出版信息

Cien Saude Colet. 2008 Sep-Oct;13(5):1543-51. doi: 10.1590/s1413-81232008000500019.

Abstract

The Family Health Strategy (FHS) provides longitudinal follow-up and integrated healthcare. This study evaluated the influence of the time of adhesion to the FHS upon the incidence of cardiovascular and cerebral vascular accidents among the elderly enrolled in the CASSI-Florianópolis. The events were selected because of their high incidence, good notification and association with risk factors the FHS is able to modify. The longer the time of adhesion to the strategy the lower the incidence of these events, demonstrating the effectiveness of the FHS. A historical cohort study was conducted with 674 senior participants (60 or more years), registered between November/2003 and March/2007. The analysis used Student's T test, bivariate and multivariate analysis with logistic regression. The independent risk factors were: age over 80 years, (OR=3,44; CI 95%: 1,8-6,2), diabetes (OR=2,62; CI 95%: 1,4-4,7), hypertension (OR=1,68; CI 95%: 1,0-2,6) and physical inactivity (OR=2,06; CI 95%: 1,2-3,2). The study found no significant association between gender, dislipidemia, obesity, smoking, alcoholism and the studied events. The long time of adhesion to the FHS showed independent protective effect (OR=0,43; CI 95%: 0,2-0,8) after adjustment to earlier covariates, being effective in reducing the incidence of cardiovascular and cerebral vascular accidents among the enrolled population of elderly.

摘要

家庭健康战略(FHS)提供纵向随访和综合医疗保健服务。本研究评估了加入FHS的时间对参与弗洛里亚诺波利斯CASSI研究的老年人中脑血管和心血管意外事件发生率的影响。选择这些事件是因为它们发病率高、报告良好且与FHS能够改变的风险因素相关。加入该战略的时间越长,这些事件的发生率越低,这表明了FHS的有效性。对2003年11月至2007年3月期间登记的674名老年参与者(60岁及以上)进行了一项历史性队列研究。分析采用了学生t检验、双变量和多变量逻辑回归分析。独立风险因素为:80岁以上(OR=3.44;95%CI:1.8-6.2)、糖尿病(OR=2.62;95%CI:1.4-4.7)、高血压(OR=1.68;95%CI:1.0-2.6)和身体活动不足(OR=2.06;95%CI:1.2-3.2)。研究发现,性别、血脂异常、肥胖、吸烟、酗酒与所研究的事件之间无显著关联。在对早期协变量进行调整后,长期加入FHS显示出独立的保护作用(OR=0.43;95%CI:0.2-0.8),有效降低了所登记老年人群中心脑血管意外事件的发生率。

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