From the aDepartment of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; bDepartment of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan; cDepartment of Emergency Medicine, Taipei Medical University, Taipei, Taiwan; dDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; eDepartment of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; fDepartment of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; gDepartment of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan; hDepartment of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; iBachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan, Taiwan; jDepartment of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan; and kDepartment of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Epidemiology. 2017 Oct;28 Suppl 1:S48-S53. doi: 10.1097/EDE.0000000000000720.
Physicians in Taiwan work in stressful workplaces and have heavy workloads, both of which may contribute to the occurrence of a stroke. However, it is not clear whether they have a higher risk of stroke. Therefore, we conducted a population-based cohort study to compare the risks of stroke between physicians and the general population and among subgroups of physicians in Taiwan.
In the National Health Insurance Research Database of Taiwan, we identified 28,062 physicians and selected 84,186 age- and sex-matched nonmedical staff beneficiaries as the references. Using conditional logistic regression, we compared the prevalence of stroke between physicians and references. In addition, we made comparisons among subgroup of physicians defined by age, sex, comorbidity, specialty, and the level of hospital.
During the study period, physicians had higher prevalence rates of hypertension (23.6% vs. 19.1%), hyperlipidemia (21.4% vs. 12.9%), and coronary artery disease (CAD) (6.4% vs. 5.7%) than the referent group, but they had a lower risk of stroke with an odds ratio of 0.61 (95% confidence interval = 0.55, 0.66) after adjusting for hypertension, diabetes, hyperlipidemia, CAD, and active worker. Among physicians, the risks were higher in those who were older or had hypertension, diabetes, hyperlipidemia, or CAD.
Despite having higher prevalence rates of hypertension, hyperlipidemia, and CAD and working in stressful workplaces with heavy workloads, our study suggests that physicians in Taiwan have a lower risk of stroke compared with the general population. These results may indicate the benefits of higher awareness and more knowledge of diseases.
台湾的医生工作压力大，工作量大，这两者都可能导致中风的发生。然而，目前尚不清楚他们是否有更高的中风风险。因此，我们进行了一项基于人群的队列研究，以比较台湾医生和一般人群以及医生亚组中风的风险。
我们在台湾全民健康保险研究数据库中确定了 28062 名医生，并选择了 84186 名年龄和性别匹配的非医务人员作为对照。使用条件逻辑回归，我们比较了医生和对照者中风的发生率。此外，我们还比较了按年龄、性别、合并症、专业和医院级别定义的医生亚组之间的差异。
在研究期间，医生组高血压（23.6%比 19.1%）、高血脂（21.4%比 12.9%）和冠心病（CAD）（6.4%比 5.7%）的患病率高于对照组，但调整高血压、糖尿病、高血脂、CAD 和在职人员后，中风的风险较低，优势比为 0.61（95%置信区间为 0.55，0.66）。在医生中，年龄较大或患有高血压、糖尿病、高血脂或 CAD 的人风险更高。
尽管台湾医生高血压、高血脂和 CAD 的患病率较高，工作压力大，工作量大，但与一般人群相比，他们中风的风险较低。这些结果可能表明，他们对疾病的认识和知识水平更高带来了益处。
