Houston Stephen, Mitchell Stuart, Evans Sally
Medical Department, United Kingdom Civil Aviation Authority, London, UK.
Aviat Space Environ Med. 2010 Aug;81(8):768-73. doi: 10.3357/asem.2748.2010.
It has been suggested that integrated cardiovascular risk management guidelines and absolute cardiovascular risk prediction scores should be used routinely in aeromedical risk assessment. In this study a cardiovascular disease (CVD) risk prediction model has been applied to UK commercial pilots as an occupational group.
This retrospective cross-sectional study measured the variables age, sex, body mass index (BMI), blood pressure, use of antihypertensive medication, current smoking, and diabetes status of commercial pilots. Individual 10-yr absolute CVD risk scores (also referred to as 10-yr global CVD risk) were calculated using a non-laboratory based Framingham Heart Study developed model.
Of the 14,379 subjects eligible for the study, none had missing values for risk factors. None of the female pilots and 9.7% of all male pilots were found to be high risk. The mean 10-yr absolute CVD risk for the entire pilot population was 8.41% (median 5.6). High-risk pilots are concentrated around 60 yr of age, (mean 59, median 60 yr) with an age range of 40-81 yr. A sub-analysis of high-risk pilots younger than 65 revealed 1137 pilots in this group.
The application of a 10-yr absolute CVD risk prediction model identified a group of pilots, previously unidentified, who may require a more comprehensive risk assessment. Pilots are continuing to fly commercially beyond the age of 60, which results in substantial increase in the CVD risk burden of the pilot population as a whole.
有人建议,综合心血管风险管理指南和绝对心血管风险预测评分应常规用于航空医疗风险评估。在本研究中,一种心血管疾病(CVD)风险预测模型已应用于英国商业飞行员这一职业群体。
这项回顾性横断面研究测量了商业飞行员的年龄、性别、体重指数(BMI)、血压、抗高血压药物使用情况、当前吸烟状况和糖尿病状态等变量。使用基于弗明汉心脏研究开发的非实验室模型计算个体10年绝对CVD风险评分(也称为10年全球CVD风险)。
在14379名符合研究条件的受试者中,没有一个风险因素存在缺失值。未发现女性飞行员中有高风险者,所有男性飞行员中有9.7%为高风险。整个飞行员群体的平均10年绝对CVD风险为8.41%(中位数为5.6)。高风险飞行员集中在60岁左右(平均59岁,中位数60岁),年龄范围为40 - 81岁。对65岁以下高风险飞行员的亚分析显示,该组有1137名飞行员。
应用10年绝对CVD风险预测模型识别出了一组此前未被识别的飞行员,他们可能需要更全面的风险评估。飞行员在60岁之后仍继续从事商业飞行,这导致整个飞行员群体的CVD风险负担大幅增加。