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哈萨克斯坦的癫痫趋势:使用 2014-2020 年统一国家电子健康系统数据进行的回顾性纵向研究。

Epilepsy trends in Kazakhstan: A retrospective longitudinal study using data from unified national electronic health system 2014-2020.

机构信息

Department of Medicine, Nazarbayev University School of Medicine, Kazakhstan.

Epileptology Centre, Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan, Kazakhstan.

出版信息

Seizure. 2024 Nov;122:58-63. doi: 10.1016/j.seizure.2024.09.022. Epub 2024 Sep 30.

Abstract

OBJECTIVE

This study is designed to estimate the epidemiology of epilepsy in Kazakhstan, using a large-scale administrative health database during 2014-2020.

METHODS

Using the Unified National Electronic Health System of Kazakhstan over a seven-year span, we explored incidence and prevalence rates, disability-adjusted life years (DALY), and all-cause mortality. Regression models using Cox proportional hazards were used to analyze the sociodemographic, mental, behavioral, and neurological factors affecting survival. Overall analyses were performed using STATA (V.16).

RESULTS

The total cohort comprised of 82,907 patients, with a significant increase in the incidence of epilepsy from 26.15 in 2014 to 88.80 in 2020 per 100,000 people. Similar trends were observed in the prevalence rates, which tripled from 26.06 in 2014 to 73.10 in 2020. While mortality rates fluctuated, the elderly and children had the greatest rates of 9.97 and 2.98 per 1000 person-years respectively. DALYs revealed a substantial disease burden, with 153,532 DALYs (824.5 per 100,000) being lost during the study period. A few comorbidities, such as cerebral palsy (adjusted hazard ratio (aHR) 2.23) and central nervous system atrophy (aHR, 27.79), markedly elevated all-cause mortality. Furthermore, extrapyramidal and movement disorders (aHR 2.16, p = 0.06) and demyelinating diseases of the central nervous system (aHR 6.36, p = 0.06) showed a trend toward increased mortality risk.

CONCLUSION

To the best of our knowledge, this is the first study from Central Asia exploring a large epilepsy cohort. The findings highlight the need for targeted interventions to address the growing burden of epilepsy, particularly among children, male sex, and those with neurological comorbities.

摘要

目的

本研究旨在利用哈萨克斯坦 2014-2020 年期间的大型医疗保健数据库,估算该国的癫痫流行病学情况。

方法

我们利用哈萨克斯坦统一国家电子医疗系统,在七年期间,探索了发病率和患病率、残疾调整生命年(DALY)以及全因死亡率。采用 Cox 比例风险回归模型,分析影响生存的社会人口学、精神、行为和神经因素。总体分析使用 STATA(V.16)完成。

结果

总队列包括 82907 名患者,癫痫发病率从 2014 年的每 10 万人 26.15 例显著增加到 2020 年的 88.80 例。患病率也呈现出类似的趋势,从 2014 年的每 10 万人 26.06 例增加到 2020 年的每 10 万人 73.10 例。虽然死亡率有所波动,但老年人和儿童的死亡率最高,分别为每 1000 人年 9.97 例和 2.98 例。DALY 显示出疾病负担较大,在研究期间,有 153532 个 DALY(每 10 万人 824.5 个)损失。少数合并症,如脑瘫(调整后的危险比 (aHR) 2.23)和中枢神经系统萎缩(aHR 27.79),显著增加了全因死亡率。此外,锥体外系和运动障碍(aHR 2.16,p = 0.06)和中枢神经系统脱髓鞘疾病(aHR 6.36,p = 0.06)显示出死亡率风险增加的趋势。

结论

据我们所知,这是中亚地区首例探索大型癫痫队列的研究。研究结果突出表明,需要采取有针对性的干预措施来应对癫痫负担的增加,特别是在儿童、男性和患有神经合并症的人群中。

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