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美国特发性颅内高压:人口统计学和社会经济差异

Idiopathic Intracranial Hypertension in the United States: Demographic and Socioeconomic Disparities.

作者信息

Ghaffari-Rafi Arash, Mehdizadeh Rana, Ko Andrew Wai Kei, Ghaffari-Rafi Shadeh, Leon-Rojas Jose

机构信息

John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States.

Queen Square Institute of Neurology, University College London, London, United Kingdom.

出版信息

Front Neurol. 2020 Sep 8;11:869. doi: 10.3389/fneur.2020.00869. eCollection 2020.

Abstract

Obesity's risk increases for low-income, female, young, and Black patients. By extrapolation, idiopathic intracranial hypertension (IIH)-a disease associated with body mass index-would potentially display socioeconomic and demographic disparities. IIH incidence (per 100,000) was investigated with respect to sex, age, income, residence, and race/ethnicity, by querying the largest United States (US) healthcare administrative dataset (1997-2016), the National (Nationwide) Inpatient Sample. Annual national incidence (with 25th and 75th quartiles) for IIH was 1.15 (0.91, 1.44). Females had an incidence of 1.97 (1.48, 2.48), larger ( = 0.0000038) than males at 0.36 (0.26, 0.38). Regarding age, largest incidence was among those 18-44 years old at 2.47 (1.84, 2.73). Low-income patients had an incidence of 1.56 (1.47, 1.82), larger ( = 0.00024) than the 1.21 (1.01, 1.36) of the middle/high. No differences (χ = 4.67, = 0.097) were appreciated between urban (1.44; 1.40, 1.61), suburban (1.30; 1.09, 1.40), or rural (1.46; 1.40, 1.48) communities. For race/ethnicity (χ = 57, = 2.57 × 10), incidence was largest for Blacks (2.05; 1.76, 2.74), followed by Whites (1.04; 0.79, 1.41), Hispanics (0.67; 0.57, 0.94), and Asian/Pacific Islanders (0.16; 0.11, 0.19). Year-to-year, incidence rose for all strata subsets except Asian/Pacific Islanders (τ = -0.84, = 0.00000068). IIH demonstrates several sociodemographic disparities. Specifically, incidences are larger for those low-income, Black, 18-44 years old, or female, while annually increasing for all subsets, except Asian/Pacific Islanders. Hence, IIH differentially afflicts the US population, yielding in healthcare inequalities.

摘要

肥胖症在低收入、女性、年轻和黑人患者中的风险增加。由此推断,特发性颅内高压(IIH)——一种与体重指数相关的疾病——可能会表现出社会经济和人口统计学差异。通过查询美国最大的医疗保健管理数据集(1997 - 2016年)即全国住院患者样本,研究了IIH发病率(每10万人)与性别、年龄、收入、居住地和种族/民族的关系。IIH的年度全国发病率(含第25和第75四分位数)为1.15(0.91,1.44)。女性发病率为1.97(1.48,2.48),高于男性的0.36(0.26,0.38)(P = 0.0000038)。在年龄方面,发病率最高的是18 - 44岁人群,为2.47(1.84,2.73)。低收入患者发病率为1.56(1.47,1.82),高于中/高收入患者的1.21(1.01,1.36)(P = 0.00024)。城市(1.44;1.40,1.61)、郊区(1.30;1.09,1.40)或农村(1.46;1.40,1.48)社区之间未发现差异(χ² = 4.67,P = 0.097)。在种族/民族方面(χ² = 57,P = 2.57×10⁻¹⁰),黑人发病率最高(2.05;1.76,2.74),其次是白人(1.04;0.79,1.41)、西班牙裔(0.67;0.57,0.94)和亚太岛民(0.16;0.11,0.19)。除亚太岛民外(τ = -0.84,P = 0.00000068),所有分层子集的发病率逐年上升。IIH表现出多种社会人口统计学差异。具体而言,低收入、黑人、18 - 44岁或女性的发病率较高,而除亚太岛民外所有子集的发病率每年都在增加。因此,IIH对美国人群的影响存在差异,导致医疗保健不平等。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a92/7506031/cbae0a67a4fa/fneur-11-00869-g0001.jpg

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