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患者报告结局中的教育不平等,但心脏患者的死亡率没有不平等:全国 DenHeart 调查与登记后随访的结果。

Educational inequality in patient-reported outcomes but not mortality among cardiac patients: Results from the national DenHeart survey with register follow-up.

机构信息

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark.

National Institute of Public Health, University of Southern Denmark, Denmark.

出版信息

Scand J Public Health. 2020 Nov;48(7):781-790. doi: 10.1177/1403494820901423. Epub 2020 Feb 3.

DOI:10.1177/1403494820901423
PMID:32009558
Abstract

This study aimed to explore whether educational level is associated with mental and physical health status, anxiety and depression symptoms and quality of life at hospital discharge and predicts cardiac events and all-cause mortality 1 year after hospital discharge in patients with ischaemic heart disease, arrhythmias, heart failure or heart valve disease. The DenHeart survey is cross-sectional and combined with data from national registers. Information on educational level and co-morbidity at hospital discharge and cardiac events and mortality 1-year post-discharge was obtained from registers. Patient-reported outcomes included SF-12, Hospital Anxiety and Depression Scale and HeartQoL. Multivariate linear and logistic regression and Cox proportional hazards regression models were used. A total of 13,145 patients were included. A significant educational gradient was found in patient-reported mental and physical health status, anxiety and depression symptoms and quality of life, with lower educational groups reporting worse outcomes in adjusted analyses. No association was found between educational level and risk of cardiac events or all-cause mortality within 1 year after hospital discharge in adjusted analyses.

摘要

这项研究旨在探讨教育水平与缺血性心脏病、心律失常、心力衰竭或心脏瓣膜病患者出院时的精神和身体健康状况、焦虑和抑郁症状以及生活质量的关系,以及是否能预测出院后 1 年内的心脏事件和全因死亡率。DenHeart 调查是一项横断面研究,结合了国家登记处的数据。从登记处获得了出院时的教育水平和合并症以及出院后 1 年的心脏事件和死亡率的信息。患者报告的结果包括 SF-12、医院焦虑和抑郁量表以及 HeartQoL。使用了多变量线性和逻辑回归以及 Cox 比例风险回归模型。共纳入 13145 名患者。在患者报告的精神和身体健康状况、焦虑和抑郁症状以及生活质量方面,发现了显著的教育梯度,调整分析显示,受教育程度较低的患者报告的结果较差。在调整分析中,未发现教育水平与出院后 1 年内的心脏事件或全因死亡率风险之间存在关联。

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