Welsh Claire E, Duz Marco, Parkin Timothy D H, Marshall John F
Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK.
School of Veterinary Medicine and Science, University of Nottingham, UK.
Prev Vet Med. 2016 Sep 1;131:137-145. doi: 10.1016/j.prevetmed.2016.07.011. Epub 2016 Jul 26.
The average age of the global human population is increasing, leading to increased interest in the effects of chronic disease and multimorbidity on health resources and patient welfare. It has been posited that the average age of the general veterinarian-attended horse population of the UK is also increasing, and therefore it could be assumed that chronic diseases and multimorbidity would pose an increasing risk here also. However, evidence for this trend in ageing is very limited, and the current prevalence of many chronic diseases, and of multimorbidity, is unknown. Using text mining of first-opinion electronic medical records from seven veterinary practices around the UK, Kaplan-Meier and Cox proportional hazard modelling, we were able to estimate the apparent prevalence among veterinarian-attended horses of nine chronic diseases, and to assess their relative effects on median life expectancy following diagnosis. With these methods we found evidence of increasing population age. Multimorbidity affected 1.2% of the study population, and had a significant effect upon survival times, with co-occurrence of two diseases, and three or more diseases, leading to 6.6 and 21.3 times the hazard ratio compared to no chronic disease, respectively. Laminitis was involved in 74% of cases of multimorbidity. The population of horses attended by UK veterinarians appears to be aging, and chronic diseases and their co-occurrence are common features, and as such warrant further investigation.
全球人口的平均年龄在增加，这使得人们对慢性病和多种疾病并存对健康资源及患者福利的影响越来越感兴趣。据推测，英国普通兽医接诊的马匹群体的平均年龄也在上升，因此可以假定慢性病和多种疾病并存在这里也会带来越来越大的风险。然而，关于这种老龄化趋势的证据非常有限，许多慢性病和多种疾病并存的当前患病率尚不清楚。通过对英国七家兽医诊所的初诊电子病历进行文本挖掘、卡普兰-迈耶分析和考克斯比例风险建模，我们能够估算出兽医接诊马匹中九种慢性病的明显患病率，并评估它们在诊断后对中位预期寿命的相对影响。通过这些方法，我们发现了马匹群体年龄上升的证据。多种疾病并存影响了1.2%的研究群体，并且对生存时间有显著影响，两种疾病同时出现以及三种或更多种疾病同时出现，导致风险比分别是无慢性病情况的6.6倍和21.3倍。蹄叶炎在74%的多种疾病并存病例中出现。英国兽医接诊的马匹群体似乎正在老龄化，慢性病及其并存是常见特征，因此值得进一步研究。
