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韩国 10 年间急性缺血性脑卒中患者接受再灌注治疗的性别和经济差异:基于国家健康保险数据库的全国人群研究

Sex and Economic Disparity Related to Reperfusion Therapies for Patients with Acute Ischemic Stroke in South Korea across a 10-Year Period: A Nationwide Population-Based Study Using the National Health Insurance Database.

机构信息

Department of Neurology, National Medical Center, Seoul 04564, Korea.

Department of Family Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul 05030, Korea.

出版信息

Int J Environ Res Public Health. 2022 Mar 5;19(5):3050. doi: 10.3390/ijerph19053050.

Abstract

A complete enumeration study was conducted to evaluate trends related to reperfusion therapies (intravenous thrombolysis (IVT) and endovascular treatment (EVT)) in acute ischemic stroke (AIS) in South Korea, according to sex, economic status, and age, over a 10-year period retrospectively, using the National Health Information Database (NHIS-2020-1-481). This study included AIS patients aged ≥20 years who were hospitalized in a general hospital or tertiary hospital for ≥4 days and underwent brain imaging during the same period. Study participants were classified by sex, economic status (Medical Aid beneficiaries and National Health Insurance beneficiaries) and age (20-44, 45-64, 65-79, and ≥80 years). Women showed a significantly lower OR (Odds ratio) than men in IVT (OR: 0.75; 95% CI: 0.73-0.77), EVT (OR: 0.96; 95% CI: 0.93-0.99), and any therapy (OR: 0.82; 95% CI: 0.80-0.84). The Medical Aid beneficiaries showed significantly lower OR in IVT (OR 0.91, 95% CI 0.88-0.95), EVT (OR 0.93, 95% CI 0.89-0.98), and either therapy (OR 0.92, 95% CI 0.90-0.95) than the National Health Insurance beneficiaries. This study showed sex and economic disparity related to reperfusion therapies in patients with AIS in Korea.

摘要

本研究利用国家健康保险服务-国民健康保险审查与评估服务数据库(NHIS-2020-1-481),回顾性地对韩国在过去 10 年中按性别、经济状况和年龄分类的急性缺血性脑卒中(AIS)患者的再灌注治疗(静脉溶栓治疗(IVT)和血管内治疗(EVT))趋势进行了全面评估。本研究纳入了年龄≥20 岁、在综合医院或三级医院住院≥4 天且同期行脑部影像学检查的 AIS 患者。研究对象按性别、经济状况(医疗补助受益人和国民健康保险受益人)和年龄(20-44 岁、45-64 岁、65-79 岁和≥80 岁)进行分类。与男性相比,女性接受 IVT(比值比(OR):0.75;95%可信区间(CI):0.73-0.77)、EVT(OR:0.96;95%CI:0.93-0.99)和任何治疗(OR:0.82;95%CI:0.80-0.84)的可能性显著更低。与国民健康保险受益人相比,医疗补助受益人接受 IVT(OR:0.91;95%CI:0.88-0.95)、EVT(OR:0.93;95%CI:0.89-0.98)和任何治疗(OR:0.92;95%CI:0.90-0.95)的可能性也显著更低。本研究表明,在韩国 AIS 患者中,再灌注治疗与性别和经济地位存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/852c/8910261/40058c2febfc/ijerph-19-03050-g001.jpg

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