Tzeng I-Shiang, Liu Su-Hsun, Chiou Yu Ting, Huang Chien-Hsiung, Lee Cheng-Jung, Chien Cheng-Yu, Hsu Shou-Chien, Weng Yi-Ming, Chen Kuan-Fu, Chen Jih-Chang
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei College of Medicine, Chang Gung University, Taoyuan Department of Family Medicine, Chang Gung Memorial Hospital, Linkou New Taipei City Limited Liability Indigenous People of Labor Cooperation Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
Medicine (Baltimore). 2016 Dec;95(50):e5598. doi: 10.1097/MD.0000000000005598.
The aim of this study was to determine the age-period-cohort (APC) effects on the rate of infection-related emergency department (ED) visits from septicemia for predicting the same in recent periods.In our study, we investigated the longitudinal trends in septicemia-related visit rates. Using an APC model to decompose the septicemia visit rates into the effects of age, time period, and cohort, and examine whether their effects varied by sex.The septicemia ED visit rate was classified as the International Classification of Disease Code 038 by primary and secondary diagnosis between 1998 and 2012.In both males and females, the visit rate of septicemia showed an increase from 2003 through 2012. An increase in septicemia visit rate after 2003 was observed in all age groups. An APC model indicated a reversal increasing period effect, which increased prominently from 2003 to 2012 in both males and females. The age effect showed an increasing trend. The cohort effect tended to show a slight oscillation from 1913 to 1988. With reference to the prediction of the logarithms of the age-specific 5-year visit rates, we observed that the younger cohorts exhibited a slightly increasing trend, as compared to the older cohorts.The period effect can explain the increase in septicemia visit rates, suggesting the role of screening for septicemia. Furthermore, it is well known that aging is a relevant risk variable for infectious diseases. The present study concludes that the aged population exhibited a strong increasing future trend for septicemia-related ED visit rates.
本研究的目的是确定年龄-时期-队列（APC）效应在败血症相关急诊科（ED）就诊率方面的影响，以预测近期的情况。在我们的研究中，我们调查了败血症相关就诊率的纵向趋势。使用APC模型将败血症就诊率分解为年龄、时期和队列的影响，并检验其影响是否因性别而异。败血症ED就诊率根据1998年至2012年的主要和次要诊断被分类为国际疾病分类代码038。在男性和女性中，败血症就诊率从2003年到2012年都呈上升趋势。在所有年龄组中都观察到2003年后败血症就诊率有所增加。APC模型表明时期效应呈反向上升，在男性和女性中从2003年到2012年都显著增加。年龄效应呈上升趋势。队列效应在1913年至1988年期间倾向于呈现轻微波动。参照特定年龄5年就诊率对数的预测，我们观察到与老年队列相比，年轻队列呈现出略有上升的趋势。时期效应可以解释败血症就诊率的增加，这表明了败血症筛查的作用。此外，众所周知，老龄化是传染病的一个相关风险变量。本研究得出结论，老年人群败血症相关ED就诊率未来呈现出强劲的上升趋势。
