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脑血管死亡率:2000-2019 年巴西各州首府的趋势和季节性。

Cerebrovascular mortality: trend and seasonality in Brazilian capitals, 2000-2019.

机构信息

Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública "Sergio Arouca". Rio de Janeiro, RJ, Brasil.

Universidade Federal Fluminense. Instituto de Matemática e Estatística. Departamento de Estatística. Niterói, RJ, Brasil.

出版信息

Rev Saude Publica. 2023 Oct 20;57:53. doi: 10.11606/s1518-8787.2023057004813. eCollection 2023.

Abstract

OBJECTIVE

To evaluate the trend and seasonality of cerebrovascular mortality rates in the adult population of Brazilian capitals from 2000 to 2019.

METHODS

This is an ecological and descriptive study of a time series of mortality due to cerebrovascular causes in adults (≥ 18 years) living in Brazilian capitals from 2000 to 2019, based on the Brazilian Mortality Information System. Descriptive statistical techniques were applied in the exploratory analysis of data and in the summary of specific, standardized rates and ratios by sociodemographic characteristics. The jointpoint regression model was used to estimate the trend of cerebrovascular mortality rates by gender, age groups, and geographic regions. The seasonal variability of rates by geographic regions was estimated using the generalized additive model by smoothing cubic splines.

RESULTS

People aged over 60 years comprised 77% of all cerebrovascular deaths. Women (52%), white individuals (47%), single people (59%), and those with low schooling (57%, elementary school) predominated in our sample. Recife (20/1,000 inhab.) and Vitória (16/1,000 inhab.) showed the highest crude mortality rates. Recife (49/10,000 inhab.) and Palmas (47/10,000 inhab.) prevailed after we applied standardized rates. Cerebrovascular mortality rates in Brazil show a favorable declining trend for adults of all genders. Seasonality influenced rate increase from July to August in almost all region capitals, except in the North, which rose in March, April, and May.

CONCLUSIONS

Deaths due to cerebrovascular causes prevailed in older single adults with low schooling. The trend showed a tendency to decline and winter, the greatest risk. Regional differences can support decision-makers in implementing public policies to reduce cerebrovascular mortality.

摘要

目的

评估 2000 年至 2019 年期间巴西首都成年人脑血管死亡率的趋势和季节性。

方法

这是一项对 2000 年至 2019 年期间居住在巴西首都的成年人(≥18 岁)因脑血管原因导致的死亡率进行时间序列的生态学和描述性研究,该研究基于巴西死亡率信息系统。在探索性数据分析和按社会人口特征汇总特定的标准化率和比率时,应用了描述性统计技术。联合点回归模型用于按性别、年龄组和地理区域估计脑血管死亡率的趋势。使用广义相加模型通过平滑三次样条来估计地理区域的速率季节性变化。

结果

60 岁以上人群占所有脑血管死亡人数的 77%。女性(52%)、白人(47%)、单身(59%)和低学历(57%,小学)的人在我们的样本中占主导地位。累西腓(20/1000 居民)和维多利亚(16/1000 居民)的粗死亡率最高。累西腓(49/10000 居民)和帕尔马斯(47/10000 居民)在应用标准化率后占主导地位。巴西成年人的脑血管死亡率呈有利的下降趋势。季节性影响了几乎所有地区首府 7 月至 8 月的死亡率上升,除了北部在 3 月、4 月和 5 月上升。

结论

脑血管原因导致的死亡主要发生在年龄较大、单身、学历较低的成年人中。趋势显示出下降的趋势,冬季风险最大。区域差异可以为决策者提供支持,以实施减少脑血管死亡率的公共政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69c6/10519683/07f564d0cd5d/1518-8787-rsp-57-53-gf01.jpg

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