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美国门诊银屑病、化脓性汗腺炎和特应性皮炎患者心血管共病的筛查。

Screening for cardiovascular comorbidity in United States outpatients with psoriasis, hidradenitis, and atopic dermatitis.

机构信息

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Department of Dermatology, George Washington University School of Medicine, 2150 Pennsylvania Avenue, Suite 2B-430, Washington, DC, 20037, USA.

出版信息

Arch Dermatol Res. 2021 Apr;313(3):163-171. doi: 10.1007/s00403-020-02087-w. Epub 2020 May 11.

Abstract

Psoriasis, hidradenitis, and atopic dermatitis (AD) are associated with increased cardiometabolic comorbidities. Yet, little is known about screening rates for cardiometabolic comorbidities in patients with these disorders. The objective of this study is to determine rates and predictors of cardiovascular screening among patients with psoriasis, AD, and hidradenitis in the United States. Data from the 2006-2015 National Ambulatory Medical Care Survey were analyzed, including 67,581 pediatric and 322,957 adult outpatient visits. Overall, blood pressure screening was performed less commonly in psoriasis (36.4% [31.0-42.2%]) and AD (41.9% [39.3-44.7%] of visits) compared to other visits (62.5% [61.5-63.6%]) (P < 0.0001). Cholesterol screening was performed more often (adjusted odds ratio [95% confidence interval]) in psoriasis (1.82 [1.20-2.76], P = 0.005) but less often in hidradenitis (0.03 [0.00-0.23], P = 0.001) and AD (0.72 [0.55-0.94], P = 0.02). Obesity screening increased from 2006-2007 to 2014-2015 in AD (31.1% [25.8-36.4%]-44.5% [37.0-81.5%], P = 0.01), psoriasis (19.0% [9.4-28.6%] to 42.8% [30.5-73.3%], P = 0.01), and hidradenitis (28.6% [1.7-55.6%] to 74.2% [55.3-100.0%], P = 0.001), but screening for blood pressure, cholesterol, or diabetes did not. Screening rates for cardiometabolic comorbidities are suboptimal. Future interventions are needed to improve screening rates for cardiometabolic comorbidities.

摘要

银屑病、化脓性汗腺炎和特应性皮炎(AD)与增加的心血管代谢合并症相关。然而,对于这些疾病患者的心血管代谢合并症的筛查率知之甚少。本研究的目的是确定美国银屑病、AD 和化脓性汗腺炎患者的心血管筛查率及其预测因素。对 2006-2015 年全国门诊医疗调查的数据进行了分析,包括 67581 名儿科和 322957 名成年门诊就诊者。总的来说,与其他就诊者(62.5%[61.5-63.6%])相比,血压筛查在银屑病(36.4%[31.0-42.2%])和 AD(41.9%[39.3-44.7%])中的实施率较低(P<0.0001)。胆固醇筛查在银屑病中更常见(调整后的优势比[95%置信区间])(1.82[1.20-2.76],P=0.005),而在化脓性汗腺炎(0.03[0.00-0.23],P=0.001)和 AD(0.72[0.55-0.94],P=0.02)中则较少。AD 中肥胖筛查从 2006-2007 年到 2014-2015 年有所增加(31.1%[25.8-36.4%]-44.5%[37.0-81.5%],P=0.01),银屑病(19.0%[9.4-28.6%]-42.8%[30.5-73.3%],P=0.01),化脓性汗腺炎(28.6%[1.7-55.6%]-74.2%[55.3-100.0%],P=0.001),但血压、胆固醇或糖尿病的筛查并未增加。心血管代谢合并症的筛查率不理想。需要采取未来的干预措施来提高心血管代谢合并症的筛查率。

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