Andersson Jonas, Wennberg Patrik, Lundblad Dan, Escher Stefan A, Jansson Jan-Håkan
Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Sweden
Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Sweden.
Eur J Prev Cardiol. 2016 Nov;23(17):1814-1820. doi: 10.1177/2047487316659574. Epub 2016 Jul 19.
More than half of cardiovascular mortality occurs outside the hospital, mainly due to consistently low survival rates from out-of-hospital cardiac arrest.
This is a prospective, nested, case-control study derived from the Västerbotten Intervention Programme and the World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease study in northern Sweden (1986-2006). To determine predictors for sudden cardiac death risk factors for cardiovascular disease were compared between incident myocardial infarction with sudden cardiac death (n = 363) and survivors of incident myocardial infarction (n = 1998) using multivariate logistic regression analysis.
Diabetes had the strongest association with sudden cardiac death out of all evaluated risk factors (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.30-2.59), followed by low education (OR 1.55, 95% CI 1.19-2.01), high body mass index (OR 1.05, 95% CI 1.02-1.08) and male sex (OR 1.42, 95% CI 1.001-2.01).
The pattern of risk factors for incident myocardial infarction is different among survivors and those who die within 24 hours. The risk factors that contribute the most to death within 24 hours are diabetes mellitus, high body mass index and low education level, and can be addressed at both the public health level and by general practitioners.
超过一半的心血管疾病死亡率发生在医院外，主要原因是院外心脏骤停的生存率一直很低。
这是一项前瞻性、嵌套式病例对照研究，源自韦斯特博滕干预计划以及世界卫生组织在瑞典北部开展的心血管疾病趋势和决定因素多国监测研究（1986 - 2006年）。为了确定心脏性猝死的预测因素，使用多因素逻辑回归分析比较了发生心肌梗死并伴有心脏性猝死的患者（n = 363）和心肌梗死幸存者（n = 1998）之间的心血管疾病危险因素。
在所有评估的危险因素中，糖尿病与心脏性猝死的关联最强（比值比（OR）1.83，95%置信区间（CI）1.30 - 2.59），其次是低教育水平（OR 1.55，95% CI 1.19 - 2.01）、高体重指数（OR 1.05，95% CI 1.02 - 1.08）和男性（OR 1.42，95% CI 1.001 - 2.01）。
心肌梗死幸存者和在24小时内死亡者的危险因素模式不同。对24小时内死亡影响最大的危险因素是糖尿病、高体重指数和低教育水平，公共卫生层面和全科医生均可针对这些因素采取措施。
