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根据自我评估健康水平得出的死亡率预测因素存在很大差异:一项18年随访研究的结果

Large variation in predictors of mortality by levels of self-rated health: Results from an 18-year follow-up study.

作者信息

Reile R, Stickley A, Leinsalu M

机构信息

Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Institute of Social Studies, University of Tartu, Tartu, Estonia; Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.

Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.

出版信息

Public Health. 2017 Apr;145:59-66. doi: 10.1016/j.puhe.2016.12.034. Epub 2017 Jan 20.

Abstract

OBJECTIVES

To analyze the variation in factors associated with mortality risk at different levels of self-rated health (SRH).

STUDY DESIGN

Retrospective cohort study.

METHODS

Cox regression analysis was used to examine the association between mortality and demographic, socioeconomic and health-related predictors for respondents with good, average, and poor SRH in a longitudinal data set from Estonia with up to 18 years of follow-up time.

RESULTS

In respondents with good SRH, male sex, older age, lower income, manual occupation, ever smoking, and heavy alcohol consumption predicted higher mortality. These covariates, together with marital status, illness-related limitations, and underweight predicted mortality in respondents with average SRH. For poor SRH, only being never married and having illness-related limitations predicted mortality risk in addition to older age and male sex.

CONCLUSIONS

The predictors of all-cause mortality are not universal but depend on the level of SRH. The higher mortality of respondents with poor SRH could to a large extent be attributed to health problems, whereas in the case of average or good SRH, factors other than the presence of illness explained outcome mortality.

摘要

目的

分析不同自评健康(SRH)水平下与死亡风险相关因素的变化情况。

研究设计

回顾性队列研究。

方法

采用Cox回归分析,在爱沙尼亚一个长达18年随访时间的纵向数据集中,研究自评健康状况良好、中等和较差的受访者的死亡率与人口统计学、社会经济和健康相关预测因素之间的关联。

结果

在自评健康状况良好的受访者中,男性、年龄较大、收入较低、体力劳动者、曾经吸烟和大量饮酒预示着更高的死亡率。这些协变量,连同婚姻状况、疾病相关限制和体重过轻,预示着自评健康状况中等的受访者的死亡率。对于自评健康状况较差的受访者,除了年龄较大和男性外,只有从未结婚和有疾病相关限制预示着死亡风险。

结论

全因死亡率的预测因素并非普遍适用,而是取决于自评健康水平。自评健康状况较差的受访者死亡率较高,在很大程度上可归因于健康问题,而在自评健康状况中等或良好的情况下,疾病以外的因素解释了结局死亡率。

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