Moryson Wacław, Kalinowski Paweł, Kotecki Paweł, Stawińska-Witoszyńska Barbara
Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
Department of Hygiene and Epidemiology, Medical University of Lublin, 20-093 Lublin, Poland.
J Clin Med. 2023 Apr 17;12(8):2913. doi: 10.3390/jcm12082913.
In the years 2020 and 2021, the COVID-19 pandemic disrupted Poland's health care system and caused a high number of excess deaths. After nearly 30 years of continuous dynamic increase in the life expectancy of the Polish population and a decrease in premature mortality that led to a reduction in the health gap between Poland and Western European countries, regrettably, a decline in life expectancy was recorded. For males, the decline amounted to 2.3 years and, for females, to 2.1 years.
The aim of this study was to assess changes in the level of premature mortality due to selected cardiovascular diseases in Poland before and during the COVID-19 pandemic.
Time trends of deaths of patients under the age of 65 due to ischemic heart disease, cerebrovascular disease and aortic aneurysm were analyzed by gender and age groups. The joinpoint model was used in determining time trends.
Premature mortality due to all of the cardiovascular diseases analyzed had been declining steadily by about 5% per year since 2008. However, at the end of the second decade of the 21st century, a significant change in the dynamics of the trend was observed, particularly with regard to deaths from ischemic heart disease, which since 2018 caused premature mortality increases of 10% per year in the female population. In the male population, an increase of nearly 20% per year has been observed since 2019. The changes also affected premature mortality due to cerebrovascular disease.
After nearly three decades of significant decline in premature mortality from cardiovascular diseases in Poland, there was a reversal in the trend, in particular as regards ischemic heart disease. The unfavorable changes intensified in the subsequent two years. The simultaneous increase in the number of cardiovascular incidents ending in death and the decline in access to prompt diagnosis and effective treatment may explain the unfavorable changes in the deaths caused by cardiovascular disease and the increase in premature mortality due to cardiovascular disease.
2020年和2021年，新冠疫情扰乱了波兰的医疗体系，并导致大量超额死亡。在波兰人口预期寿命持续近30年动态增长以及过早死亡率下降，从而使波兰与西欧国家之间的健康差距缩小之后，令人遗憾的是，预期寿命出现了下降。男性下降了2.3岁，女性下降了2.1岁。
本研究的目的是评估新冠疫情之前及期间波兰因某些心血管疾病导致的过早死亡率的变化。
按性别和年龄组分析了65岁以下患者因缺血性心脏病、脑血管疾病和主动脉瘤导致的死亡时间趋势。采用连接点模型确定时间趋势。
自2008年以来，所有分析的心血管疾病导致的过早死亡率每年稳步下降约5%。然而，在21世纪第二个十年末，趋势动态出现了显著变化，特别是在缺血性心脏病死亡方面，自2018年以来，女性人群的过早死亡率每年增加10%。在男性人群中，自2019年以来，每年增加近20%。这些变化也影响了脑血管疾病导致的过早死亡率。
在波兰心血管疾病过早死亡率近三十年显著下降之后，趋势出现了逆转，特别是在缺血性心脏病方面。在随后的两年里，不利变化加剧。心血管疾病死亡事件数量的同时增加以及及时诊断和有效治疗可及性的下降，可能解释了心血管疾病导致的死亡的不利变化以及心血管疾病过早死亡率的增加。
