Department of Epidemiology, Cardiovascular Diseases Prevention and Promotion Health, Institute of Cardiology, ul. Alpejska 42, Warsaw, Poland.
Kardiol Pol. 2012;70(12):1225-34.
A decrease in cardiovascular mortality rates, including deaths due to ischaemic heart disease (IHD), has been observed in Poland since mid-1990s, and at the same time a rapid increase in sudden cardiovascular death (SCD) rate was noted.
To evaluate changes in mortality due to SCD, IHD and SCD+IHD that occurred in 2003-2008 in the Polish population aged 25-64 years.
Individual data from death certificates and demographic data were obtained from the Central Statistical Office and all analyses were performed in the Department of Cardiovascular Disease Epidemiology, Prevention and Health Promotion. SCD was defined as codes I46.1 and R96, and IHD as codes I20-I25 according to the Tenth Revision of the International Classification of Diseases (ICD-10). Calculated mortality rates per 100,000 inhabitants for 5-year age groups were standardised for the European population structure.
In 1997-2008, premature mortality due to SCD among adult men and women aged 25-64 years showed only small variations until 2003, and later an upward trend was observed. In 2005-2008, mortality due to SCD increased by 40% among men and 45% among women, but total mortality due to SCD+IHD remained stable. There was no marked variation in the proportion of mortality due to IHD+SCD in total cardiovascular disease (CVD) mortality both in men and in women. The rate of SCD was related to age. A notable finding was the equalisation of mortality rates due to IHD+SCD per 100,000 in nearly all age groups except for the oldest men and women. In the whole adult Polish population, no clear difference in standardised mortality rates could be noted between 2003 and 2008. SCD mortality rate and its proportion in total CVD mortality differed significantly in relation to the region of Poland. SCD mortality rate among men in the Lubusz and Lesser Poland voivodeships decreased by more than 25% (in women only in the Lubusz voivodeship). In the remaining voivodeships, increases in SCD mortality rate were observed (among men, by 171% in the Pomeranian voivodeship, 66% in the Świętokrzyskie voivodeship, and 60% in the Opole voivodeship; among women, by 248% in the Pomeranian voivodeship, 88% in the Silesian voivodeship, and 85% in the Opole voivodeship). No differences in mortality rates due to IHD+SCD in relation to the region of Poland were observed.
IHD mortality rates in the Polish population aged 25-64 years were underestimated in the majority of voivodeships. At the same time, SCD mortality rates were overestimated. These results indicate deficiencies in our medical care system regarding the diagnosis and prevention of sudden deaths, and awareness of symptoms of life-threatening conditions.
自 20 世纪 90 年代中期以来，波兰的心血管死亡率（包括缺血性心脏病[IHD]导致的死亡）有所下降，与此同时，猝死（SCD）的发生率也迅速上升。
评估 2003-2008 年波兰 25-64 岁人群 SCD、IHD 和 SCD+IHD 导致的死亡率变化。
从中央统计局获得死亡证明和人口统计数据的个人数据，所有分析均在心血管疾病流行病学、预防和健康促进系进行。SCD 定义为国际疾病分类第 10 次修订版（ICD-10）中的代码 I46.1 和 R96，IHD 定义为代码 I20-I25。根据欧洲人口结构，对每 10 万人的 5 年年龄组死亡率进行标准化。
在 1997-2008 年，25-64 岁成年男性和女性的 SCD 导致的早逝率在 2003 年之前仅略有变化，此后呈上升趋势。2005-2008 年，男性 SCD 死亡率增加了 40%，女性增加了 45%，但 SCD+IHD 总死亡率保持稳定。在男性和女性中，IHD+SCD 导致的死亡率在总心血管疾病（CVD）死亡率中的比例均无明显变化。SCD 率与年龄有关。一个显著的发现是，除了最年长的男性和女性外，几乎所有年龄组的 IHD+SCD 死亡率都趋于均等。在整个成年波兰人群中，2003 年和 2008 年之间的标准化死亡率没有明显差异。SCD 死亡率及其在总 CVD 死亡率中的比例在波兰各地区之间存在显著差异。卢布斯克和小波兰省的男性 SCD 死亡率下降了 25%以上（女性仅在卢布斯克省下降）。在其余省份，SCD 死亡率上升（男性在波美拉尼亚省上升 171%，在圣十字省上升 66%，在奥波莱省上升 60%；女性在波美拉尼亚省上升 248%，在西里西亚省上升 88%，在奥波莱省上升 85%）。波兰各地区的 IHD+SCD 死亡率无差异。
在大多数省，25-64 岁波兰人群的 IHD 死亡率被低估。与此同时，SCD 死亡率被高估。这些结果表明，我们的医疗保健系统在诊断和预防猝死以及对危及生命的疾病症状的认识方面存在缺陷。
