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调查住院人群中非传染性疾病的患病率、模式和患者结局:三家三级医院的前瞻性观察研究。

Investigation of non-communicable diseases prevalence, patterns, and patient outcomes in hospitalized populations: a prospective observational study in three tertiary hospitals.

机构信息

Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Colleges of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Hubert Department of Global Health, Rollins School of Public Health, Emory University, Georgia, Atlanta, USA.

出版信息

J Health Popul Nutr. 2024 Aug 20;43(1):128. doi: 10.1186/s41043-024-00599-z.

Abstract

BACKGROUND

Non-communicable diseases (NCDs) pose a significant global health challenge, constituting over 80% of mortality and morbidity. This burden is particularly pronounced in low- and middle-income countries (LMICs), including Ethiopia. Despite this, there's limited research on this issue in Africa. This study aims to investigate the prevalence, patterns, and outcomes of NCDs in hospitalized populations across three tertiary hospitals in Ethiopia.

METHODS

A hospital-based cohort study (August 2022 - January 2023) included patients aged 14 and older diagnosed with cardiovascular diseases (CVDs), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), asthma, or cancer at three Ethiopian hospitals. Data on demographics, socio-economic factors, clinical characteristics, and outcomes were collected through medical records and interviews. Logistic regression identified factors independently associated with in-hospital mortality, with p ≤ 0.05 considered statistically significant.

RESULTS

In the study across three tertiary hospitals involving 2,237 patients, we uncovered the impact of NCDs. About 23.4% of patients struggled with NCDs, with cardiovascular diseases (53.3%), cancer (29.6%), diabetes (6.1%), and respiratory diseases (6.5%) being the most prevalent. Notably, among those affected, women comprised a slight majority (55.1%), with the average patient age being 47.2 years. Unfortunately, 15.3% of patients with NCDs faced in-hospital mortality. Our analysis revealed predictors of mortality, including cancer diagnosis (adjusted odds ratio [AOR]:1.6, 95% CI: 1.2-1.8, p = 0.01), medication adherence ( AOR: 0.36, 95% CI: 0.21-0.64, p < 0.001), concurrent infections (AOR: 0.36, 95% CI: 0.16-0.86, p < 0.001), chronic kidney diseases (CKD) (AOR: 0.35, 95% CI: 0.14-0.85, p = 0.02), and complications during hospitalization (AOR: 6.36, 95% CI: 3.45-11.71, p < 0.001).

CONCLUSION

Our study reveals a substantial prevalence of NCDs among hospitalized patients, affecting approximately one in four individuals, primarily with CVDs and cancer. Alarmingly, a significant proportion of these patients did not survive their hospitalization, emphasizing the urgent need for targeted interventions to enhance outcomes in this population.

摘要

背景

非传染性疾病(NCDs)对全球健康构成重大挑战,占全球死亡和发病的 80%以上。这一负担在中低收入国家(LMICs)尤为明显,包括埃塞俄比亚。尽管如此,非洲对此问题的研究有限。本研究旨在调查埃塞俄比亚三家三级医院住院人群中 NCD 的患病率、模式和结局。

方法

这是一项基于医院的队列研究(2022 年 8 月至 2023 年 1 月),包括在三家埃塞俄比亚医院被诊断为心血管疾病(CVDs)、糖尿病(DM)、慢性阻塞性肺疾病(COPD)、哮喘或癌症的年龄在 14 岁及以上的患者。通过病历和访谈收集人口统计学、社会经济因素、临床特征和结局数据。逻辑回归确定了与院内死亡率独立相关的因素,p 值≤0.05 被认为具有统计学意义。

结果

在这项涉及三家三级医院的 2237 名患者的研究中,我们发现了 NCD 的影响。约 23.4%的患者患有 NCD,其中心血管疾病(53.3%)、癌症(29.6%)、糖尿病(6.1%)和呼吸系统疾病(6.5%)最为常见。值得注意的是,在这些患者中,女性略占多数(55.1%),平均患者年龄为 47.2 岁。不幸的是,15.3%的 NCD 患者面临院内死亡。我们的分析揭示了死亡率的预测因素,包括癌症诊断(调整后的优势比 [AOR]:1.6,95%置信区间:1.2-1.8,p=0.01)、药物依从性(AOR:0.36,95%置信区间:0.21-0.64,p<0.001)、合并感染(AOR:0.36,95%置信区间:0.16-0.86,p<0.001)、慢性肾脏病(CKD)(AOR:0.35,95%置信区间:0.14-0.85,p=0.02)和住院期间并发症(AOR:6.36,95%置信区间:3.45-11.71,p<0.001)。

结论

我们的研究表明,住院患者中非传染性疾病的患病率相当高,约每四人中就有一人患病,主要是心血管疾病和癌症。令人担忧的是,这些患者中有相当大的比例在住院期间没有存活下来,这强调了迫切需要针对这一人群进行有针对性的干预,以改善结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76af/11337899/ffbf28f2e6a3/41043_2024_599_Fig1_HTML.jpg

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