Lew J F, Glass R I, Gangarosa R E, Cohen I P, Bern C, Moe C L
Viral Gastroenteritis Unit, Centers for Disease Control, Atlanta, GA 30333.
JAMA. 1991 Jun 26;265(24):3280-4.
--Diarrhea is an important cause of death among young children in both developing and developed countries, but little is known about diarrheal death among adults. In this study, we examined trends in diarrheal deaths among all age groups in the United States.
DESIGN/SETTING/PARTICIPANTS: --We reviewed national mortality data complied by the National Center for Health Statistics, Hyattsville, Md, which consists of information from all death certificates filed in the United States for the period 1979 through 1987. A death for which diarrhea was listed as an immediate or underlying cause was considered a "diarrheal death" and included in the analysis.
--We found that 28,538 persons died of diarrhea cited as either an immediate or the underlying cause of death during the 9-year period. A majority of diarrheal deaths occurred among the elderly (older than 74 years of age, 51%), followed by adults 55 to 74 years of age (27%), and young children (younger than 5 years of age, 11%). For the elderly, adjusted risk factors for dying of diarrhea included being white, female, and residing in a long-term care facility. Only the elderly and young children had clear, distinct winter peaks of diarrheal deaths, suggesting that the diarrhea may, in part, be infectious in origin.
--For the elderly, more directed studies of those at risk, such as nursing home residents, are needed to determine if oral rehydration therapy, vaccines, or other preventive measures might benefit this population.
——腹泻是发展中国家和发达国家幼儿死亡的一个重要原因，但对于成人腹泻死亡情况却知之甚少。在本研究中，我们调查了美国所有年龄组腹泻死亡的趋势。
设计/地点/参与者：——我们回顾了由马里兰州海茨维尔市国家卫生统计中心汇编的全国死亡率数据，该数据包含1979年至1987年期间在美国提交的所有死亡证明中的信息。腹泻被列为直接或根本死因的死亡被视为“腹泻死亡”并纳入分析。
——我们发现，在这9年期间，有28538人死于被列为直接或根本死因的腹泻。大多数腹泻死亡发生在老年人（74岁以上，51%）中，其次是55至74岁的成年人（27%）和幼儿（5岁以下，11%）。对于老年人，死于腹泻的调整后风险因素包括为白人、女性以及居住在长期护理机构。只有老年人和幼儿有明显的腹泻死亡冬季高峰，这表明腹泻部分可能源于感染。
——对于老年人，需要针对高危人群（如养老院居民）进行更具针对性的研究，以确定口服补液疗法、疫苗或其他预防措施是否可能使该人群受益。
