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叙利亚难民儿童先天性心脏病:发展中国家一家三级保健中心的经验。

Congenital Heart Disease in Syrian Refugee Children: The Experience at a Tertiary Care Center in a Developing Country.

机构信息

Division of Cardiology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Department of Pediatrics and Adolescent Medicine, Medical Center (AUBMC), American University of Beirut, PO Box: 11-0236, Beirut, 1107 2020, Lebanon.

出版信息

Pediatr Cardiol. 2021 Jun;42(5):1010-1017. doi: 10.1007/s00246-021-02574-5. Epub 2021 Mar 18.

Abstract

The influx of Syrian refugees to Lebanon that began in 2012 created new health-care and financial stressors on the country with an increase in communicable and non-communicable diseases. This study aims to describe the presentations, diagnoses, management, financial burden, and outcomes among Syrian refugees with congenital heart disease (CHD) in Lebanon. This is a retrospective study that was conducted through reviewing the charts of all Syrian pediatric patients referred to the Children's Heart Center at the American University of Beirut Medical Center for evaluation between the years 2012 and 2017. We reviewed the charts of 439 patients. The mean age at presentation was 3.97 years, and 205 patients (46.7%) were females. 99 Patients (22.6%) were found to have no heart disease, 69 (15.7%) had simple, 146 (33.3%) had moderate, and 125 (28.5%) had complex heart diseases. 176 (40.1%) Patients underwent interventional procedures, with a surgical mortality rate of 10.1%, compared to a rate of 2.9% among non-Syrian children. The average cost per surgical procedure was $15,160. CHD poses a significant health and financial burden on the Syrian refugee population in Lebanon, a small country with very limited resources. The Syrian cohort had a higher frequency of complex cardiac lesions, presented late with additional comorbidities, and had a strikingly elevated surgical mortality rate. Securing appropriate funds can improve the lives of this population, ease the financial burden on the hosting country, provide adequate health-care services, and improve morbidity and mortality.

摘要

2012 年开始,大量叙利亚难民涌入黎巴嫩,导致该国传染性和非传染性疾病的发病率上升,从而给医疗保健和财政带来了新的压力。本研究旨在描述在黎巴嫩的叙利亚先天性心脏病(CHD)难民的临床表现、诊断、治疗、经济负担和结局。这是一项回顾性研究,通过回顾 2012 年至 2017 年间所有被转诊到贝鲁特美国大学医学中心儿童心脏中心进行评估的叙利亚儿科患者的病历。我们共回顾了 439 名患者的病历。就诊时的平均年龄为 3.97 岁,205 名患者(46.7%)为女性。99 名患者(22.6%)无心脏病,69 名(15.7%)为简单心脏病,146 名(33.3%)为中度心脏病,125 名(28.5%)为复杂心脏病。176 名(40.1%)患者接受了介入治疗,手术死亡率为 10.1%,而非叙利亚儿童的手术死亡率为 2.9%。每例手术的平均费用为 15160 美元。CHD 给黎巴嫩的叙利亚难民人口带来了巨大的健康和经济负担,而黎巴嫩是一个资源非常有限的小国。叙利亚患者群体中复杂心脏病变的发生率更高,就诊时伴有更多的合并症,手术死亡率明显升高。确保获得适当的资金可以改善这一人群的生活,减轻收容国的经济负担,提供充足的医疗保健服务,并降低发病率和死亡率。

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