Nahon Stéphane, Lahmek Pierre, Macaigne Gilles, Faurel Jean-Pierre, Sass Catherine, Howaizi Mehran, Fleury Antoine, Baju A, Locher Christophe, Barjonet Georges, Saillant GillesGatineau, Moulin Jean-Jacques, Poupardin Cécile
Hôpital de Montfermeil, France.
Inflamm Bowel Dis. 2009 Apr;15(4):594-8. doi: 10.1002/ibd.20794.
Socioeconomic deprivation is associated with poor health. The aims of this study were to evaluate the influence of deprivation in the characteristics and comparisons of deprived and nondeprived Crohn's disease (CD) patients.
CD patients were prospectively recruited from September 2006 to June 2007 in 6 hospitals in the Paris area. To assess the level of deprivation we used the EPICES score (Evaluation of Precarity and Inequalities in Health Examination Centers; http://www.cetaf.asso.fr), a validated individual index of deprivation developed in France, a score >30 defining deprivation. We defined CD as severe when at least 1 of the conventionally predefined criteria of clinical severity was present.
In all, 207 patients (128 women and 79 men, mean age 40 years) were included and had a median score of deprivation of 20.7 (0-100). Seventy-three (35%) were deprived. There were no statistical differences between deprived and nondeprived patients for the following parameters: 1) mean age: 39 +/- 14.6 versus 40.6 +/- 13.5, P = 0.4; 2) sex ratio (female/male): 87/47 (65%) versus 41/32 (56%), P = 0.2; 3) duration of disease (years) 9 +/- 8.8 versus 8.5 +/- 7.2, P = 0.7; 4) delay from onset of symptoms to diagnosis >1 year: 22/115 (19%) versus 13/63 (21%), P = 0.8; and 5) severity of disease 71% versus 70% (P = 0.9). Nondeprived patients had a lower rate of hospitalization (40 versus 56%, P = 0,04) and a higher rate of surgery (44 versus 22%, P = 0,004); the rate of surgery was only identified by logistic regression.
In this study deprivation does not seem to influence the severity of CD. This can be explained by easy access to healthcare in France.
社会经济贫困与健康状况不佳相关。本研究的目的是评估贫困对贫困和非贫困克罗恩病(CD)患者特征的影响,并进行比较。
2006年9月至2007年6月期间,在巴黎地区的6家医院前瞻性招募CD患者。为评估贫困水平,我们使用了EPICES评分(健康检查中心的不稳定和不平等评估;http://www.cetaf.asso.fr),这是一种在法国开发并经过验证的个体贫困指数,评分>30定义为贫困。当存在至少一项传统预定义的临床严重程度标准时,我们将CD定义为严重。
共纳入207例患者(128例女性和79例男性,平均年龄40岁),贫困中位数评分为20.7(0 - 100)。73例(35%)为贫困患者。在以下参数方面,贫困和非贫困患者之间无统计学差异:1)平均年龄:39 ± 14.6岁对40.6 ± 13.5岁,P = 0.4;2)性别比(女性/男性):87/47(65%)对41/32(56%),P = 0.2;3)病程(年)9 ± 8.8对8.5 ± 7.2,P = 0.7;4)从症状出现到诊断的延迟>1年:22/115(19%)对13/63(21%),P = 0.8;5)疾病严重程度71%对70%(P = 0.9)。非贫困患者的住院率较低(40%对56%,P = 0.04),手术率较高(44%对22%,P = 0.004);手术率仅通过逻辑回归确定。
在本研究中,贫困似乎不影响CD的严重程度。这可以通过法国便捷的医疗服务来解释。