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2020 年美国营养性贫血患者的住院情况。

Hospitalization of patients with nutritional anemia in the United States in 2020.

机构信息

Department of Environmental Hygiene, Public Health College, Harbin Medical University, Harbin, Heilongjiang, China.

出版信息

Front Public Health. 2024 May 13;12:1333069. doi: 10.3389/fpubh.2024.1333069. eCollection 2024.

Abstract

BACKGROUND

Nutritional anemia is highly prevalent and has triggered a globally recognized public health concern worldwide.

OBJECTIVE

To better understand the prevalence of anemia and the state of nutritional health in developed countries to inform global nutritional health and better manage the disease.

METHOD

We employed the Healthcare Cost and Utilization Project (HCUP)-2020 National Inpatient Health Care Data (NIS), administered by The Agency for Healthcare Research and Quality. Nutritional anemia was diagnosed according to the International Classification of Diseases, 10th Revision (ICD-10). Matching analysis and multivariate regression were used to adjust for patient and hospital characteristics. Controls were obtained by stratifying and matching for age and sex.

RESULTS

The 2020 HCUP-NIS database encompassed a survey over 6.4 million hospitalized patients, among which 1,745,350 patients diagnosed with anemia, representing approximately 26.97% of the hospitalized population, over 310,000 were diagnosed with nutritional anemia, and 13,150 patients were hospitalized for nutritional anemia as primary diagnosis. Hospitalization rate for nutritional anemia exhibited an increased age-dependent increase nationwide, especially among females, who displayed 1.87 times higher than males. Notably, in comparison to the control group, individuals of the Black race exhibit a higher prevalence of nutritional anemia (case group: 21.7%, control group: 13.0%, < 0.001). In addition, hospitalization rates were higher among low-income populations, with lower rates of private insurance (case group: 18.7%, control group: 23.5%, < 0.001) and higher rates of Medicaid insurance (case group: 15.4%, control group: 13.9%, < 0.001). In areas characterized by larger urban centers and advanced economic conditions within the urban-rural distribution, there was an observed increase in the frequency of patient hospitalizations. Iron deficiency anemia emerged as the predominant subtype of nutritional anemia, accounting for 12,214 (92.88%). Secondary diagnosis among patients hospitalized for nutritional anemia revealed that a significant number faced concurrent major conditions like hypertension and renal failure.

CONCLUSION

In economically prosperous areas, greater attention should be given to the health of low-income individuals and the older adult. Our findings hold valuable insights for shaping targeted public health policies to effectively address the prevalence and consequences of nutritional anemia based on a overall population health.

摘要

背景

营养性贫血在全球范围内广泛存在,已成为全球公认的公共卫生问题。

目的

了解发达国家贫血的患病率和营养健康状况,为全球营养健康提供信息,并更好地管理该疾病。

方法

我们使用了医疗保健成本和利用项目(HCUP)-2020 年全国住院患者健康护理数据(NIS),由医疗保健研究与质量局管理。营养性贫血的诊断依据国际疾病分类,第十版(ICD-10)。采用匹配分析和多元回归调整患者和医院特征。对照通过分层和匹配年龄和性别获得。

结果

2020 年 HCUP-NIS 数据库涵盖了超过 640 万例住院患者的调查,其中 1745350 例患者被诊断为贫血,占住院患者的 26.97%以上,超过 310000 例被诊断为营养性贫血,13150 例患者因营养性贫血为主要诊断而住院。全国范围内,营养性贫血的住院率呈随年龄增长而增加的趋势,尤其是女性,其发病率是男性的 1.87 倍。值得注意的是,与对照组相比,黑种人患营养性贫血的比例更高(病例组:21.7%,对照组:13.0%,<0.001)。此外,低收入人群的住院率较高,私人保险率较低(病例组:18.7%,对照组:23.5%,<0.001),医疗补助保险率较高(病例组:15.4%,对照组:13.9%,<0.001)。在城乡分布中,城市中心较大且经济条件较好的地区,患者住院的频率增加。缺铁性贫血是营养性贫血的主要亚型,占 12214 例(92.88%)。因营养性贫血住院的患者的二级诊断显示,相当数量的患者同时患有高血压和肾衰竭等主要疾病。

结论

在经济繁荣地区,应更加关注低收入人群和老年人的健康。我们的研究结果为制定有针对性的公共卫生政策提供了有价值的见解,以便根据总体人口健康状况,有效应对营养性贫血的患病率和后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4133/11128583/882196f57a34/fpubh-12-1333069-g001.jpg

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