成人叙利亚难民的心脏病：约旦大学医院的经验。
Heart Disease in Adult Syrian Refugees: Experience at Jordan University Hospital.
机构信息
General Surgery Department, School of Medicine, The University of Jordan, Amman.
出版信息
Ann Glob Health. 2019 Mar 14;85(1):36. doi: 10.5334/aogh.2474.
BACKGROUND
Since 2011, 1.26 million Syrians have immigrated to Jordan, increasing demands on Healthcare service. Information about cardiovascular disease (CVD) in Syrian refugees in general, and specifically in Jordan, is unknown.
OBJECTIVES
The study aimed to describe CVD in Syrian refugee adults who were referred to Jordan University Hospital (JUH) in terms of diagnosis, presentation, outcome, sources of funding for treatment, and to follow these patients after their discharge.
METHODS
From January 2012 to October 2016, retrospective analysis was performed on the data of Syrian patients who were referred to JUH. This study describes the diagnoses, treatment, and outcome. It also discusses the funding sources; a follow-up was conducted until January 2017.
RESULTS
There were 969 patients referred to JUH with CVD; median age was 56 years, 686 (72.2%) of them were males and 283 (27.8%) were females. Of the patients, 584 had hypertension (60%), 308 (31%) had diabetes mellitus, 281 (29.0%) suffered from dyslipidemia, and 237 were smokers (24%). There were 69.6% who had coronary artery disease (CAD) and 20 patients (2%) had valvular heart disease. Treatment was offered to 489 patients (49.5%), but only 322 (65.8% of treatment offered and 33.2% of referrals) of them received the intended treatment. Mortality rate was 3% and loss of follow-up was 49.2%. Funding for procedures mostly came from the Jordanian Health Aid Organization, the United Nations, NGOs, and charities. Sixty-four (13.3% of referred) patients were denied any funding during the time frame of this study.
CONCLUSIONS
CVD is a major issue for both Syrian refugee patients and the Jordanian healthcare system. CAD and classic cardiovascular risk factors (specifically arterial hypertension, diabetes, and dyslipidemia) are most common in this specific population. Inadequate primary healthcare, suboptimal living conditions, lack of funding, and loss of patient contact are among the major challenges facing this vulnerable population.
背景
自 2011 年以来，已有 126 万叙利亚人移民到约旦，这对医疗保健服务提出了更高的要求。目前，我们对于叙利亚难民的心血管疾病（CVD）信息知之甚少，特别是在约旦的情况。
目的
本研究旨在描述在约旦大学医院（JUH）就诊的叙利亚成年难民患者的 CVD 情况，包括诊断、表现、结局、治疗资金来源，并对这些患者出院后的情况进行随访。
方法
2012 年 1 月至 2016 年 10 月，对转诊至 JUH 的叙利亚患者的数据进行了回顾性分析。本研究描述了诊断、治疗和结局，并讨论了资金来源，随访截至 2017 年 1 月。
结果
共有 969 例患有 CVD 的患者转诊至 JUH，中位年龄为 56 岁，其中 686 例（72.2%）为男性，283 例（27.8%）为女性。584 例（60%）患有高血压，308 例（31%）患有糖尿病，281 例（29.0%）患有血脂异常，237 例（24%）为吸烟者。69.6%的患者患有冠状动脉疾病（CAD），20 例（2%）患有心脏瓣膜病。为 489 例（49.5%）患者提供了治疗，但只有 322 例（治疗提供的 65.8%和转诊的 33.2%）接受了预期的治疗。死亡率为 3%，失访率为 49.2%。治疗费用主要来自约旦卫生援助组织、联合国、非政府组织和慈善机构。在本研究期间，有 64 名（转诊的 13.3%）患者未获得任何资金。
结论
CVD 是叙利亚难民患者和约旦医疗保健系统的一个主要问题。CAD 和经典心血管危险因素（特别是动脉高血压、糖尿病和血脂异常）在这一特定人群中最为常见。初级保健不足、生活条件不佳、资金缺乏以及患者失联是这一弱势群体面临的主要挑战。
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