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1999 - 2020年美国医疗事故相关心血管死亡率的全国趋势。

National trends of malpractice-related cardiovascular mortality within the United States, 1999-2020.

作者信息

Ashraf Hamza, Ashfaq Haider, Paryani Neha Saleem, Malik Shanza, Shaikh Ali Tariq, Saleh Aalaa, Khan Jehanzeb Ahmed, Hameed Ishaque

机构信息

Departments ofCardiology.

Medicine, Allama Iqbal Medical College, Lahore.

出版信息

Ann Med Surg (Lond). 2024 Jul 23;86(9):5389-5393. doi: 10.1097/MS9.0000000000002399. eCollection 2024 Sep.

Abstract

Cardiovascular disease (CVD) stands as the leading cause of mortality in the USA, claiming a life every 33 seconds, while cardiology ranks among the top three specialties with malpractice-related claims. The authors' study aims to scrutinize sex disparities in CVD-related mortality linked with malpractice among the elderly population (≥65 years) in the USA. Data pertaining to malpractice incidents in CVD treatment spanning from 1999 to 2020 were sourced from the CDC Wonder database. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were computed. Joinpoint regression analysis was used to determine the annual percent changes (APCs) with a 95% CI, stratified across variables such as age, race/ethnicity, census region, and urban or rural settings. Over the investigated period, 2432 deaths in the US were attributed to CVD-related malpractice, with an AAMR of 2.7. Initially stable (1999-2004), mortality rates experienced a significant decline until 2020. Females consistently exhibited a higher AAMR (2.7) than males (2.6). Notably, NH Black females recorded the highest AAMR (3.1), while NH Black males and NH Asian females reported the lowest (2.5). Furthermore, NH White males demonstrated a higher AAMR (2.7) than NH Black males (2.5); conversely, NH Black females exhibited a higher AAMR (3.1) than NH White females (2.7). Mortality rates were notably elevated in the West compared to the South, with both urban and rural areas indicating higher AAMRs in females. The authors' findings underscore the necessity for targeted interventions to address the pronounced disparities, particularly among NH Black women, individuals in the West, males, and urban locales.

摘要

心血管疾病(CVD)是美国的首要死因,每33秒就有一人丧生,而心脏病学是医疗事故相关索赔最多的三大专科之一。作者的研究旨在审视美国老年人群(≥65岁)中与医疗事故相关的心血管疾病死亡率的性别差异。1999年至2020年期间心血管疾病治疗中医疗事故事件的数据来自疾病控制与预防中心(CDC)的Wonder数据库。计算了每100万人的年龄调整死亡率(AAMR)。采用Joinpoint回归分析确定年度百分比变化(APC)及其95%置信区间,并按年龄、种族/族裔、人口普查区域以及城市或农村环境等变量进行分层。在调查期间,美国有2432例死亡归因于与心血管疾病相关的医疗事故,年龄调整死亡率为2.7。死亡率最初较为稳定(1999 - 2004年),到2020年经历了显著下降。女性的年龄调整死亡率(2.7)始终高于男性(2.6)。值得注意的是,非西班牙裔黑人女性的年龄调整死亡率最高(3.1),而非西班牙裔黑人男性和非西班牙裔亚裔女性的年龄调整死亡率最低(2.5)。此外,非西班牙裔白人男性的年龄调整死亡率(2.7)高于非西班牙裔黑人男性(2.5);相反,非西班牙裔黑人女性的年龄调整死亡率(3.1)高于非西班牙裔白人女性(2.7)。与南部相比,西部的死亡率显著升高,城市和农村地区女性的年龄调整死亡率均更高。作者的研究结果强调了有针对性干预措施的必要性,以解决明显的差异,特别是在非西班牙裔黑人女性、西部人群、男性和城市地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68e9/11374185/5450bccbacff/ms9-86-5389-g001.jpg

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