特定疾病生存趋势分析中人口预期寿命改善的影响
The Impact of Improved Population Life Expectancy in Survival Trend Analyses of Specific Diseases.
作者信息
van Walraven Carl
机构信息
Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Departments of Medicine and Epidemiology & Community Medicine, University of Ottawa, Ottawa, ON, Canada.
出版信息
Health Serv Res. 2016 Aug;51(4):1632-43. doi: 10.1111/1475-6773.12403. Epub 2015 Oct 20.
BACKGROUND
Survival trend analyses examine mortality outcomes over time. The impact of conducting survival trend analyses without accounting for improved population survival has not been systematically studied.
METHODS
The 1-year risk of death in the 100 most common hospital admissions for Ontario adults in 1994, 1999, 2004, and 2009 was determined. Generalized linear models were used to determine if adjusted death risk changed significantly over time with and without accounting for population survival.
RESULTS
The statistical significance of temporal trends in survival changed after accounting for population life expectancy in 16 diagnoses (16 percent) (in 13 of 55 diagnoses, statistically significant decreasing mortality trends became insignificant; in 3 of 15 diagnoses, insignificant trends changed to a significant increase in mortality risk over time).
CONCLUSIONS
These results highlight the importance of accounting for population life-expectancy changes in survival trend analyses.
背景
生存趋势分析研究随时间推移的死亡率结果。在未考虑人群生存改善的情况下进行生存趋势分析的影响尚未得到系统研究。
方法
确定了1994年、1999年、2004年和2009年安大略省成年人100种最常见住院疾病的1年死亡风险。使用广义线性模型来确定在考虑和不考虑人群生存的情况下，调整后的死亡风险是否随时间显著变化。
结果
在16种诊断（16%）中，考虑人群预期寿命后，生存时间趋势的统计学显著性发生了变化（在55种诊断中的13种中，具有统计学显著性的死亡率下降趋势变得不显著；在15种诊断中的3种中，不显著的趋势随时间变化为死亡率风险显著增加）。
结论
这些结果凸显了在生存趋势分析中考虑人群预期寿命变化的重要性。
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