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西班牙静脉血栓栓塞症死亡率的地区差异与趋势(1999 - 2022年)

Regional Disparities and Trends in Venous Thromboembolism Mortality in Spain (1999-2022).

作者信息

Cayuela Lucia, Gaeta Anna Michela, Otero Remedios, Jara-Palomares Luis, Mendo Pedrajas Isabel, Cayuela Aurelio

机构信息

Department of Internal Medicine, Hospital Universitario Severo Ochoa, Leganés, Spain.

Pulmonology Department, Hospital Universitario Severo Ochoa, Leganés, Spain.

出版信息

Arch Bronconeumol. 2025 May;61(5):274-281. doi: 10.1016/j.arbres.2024.10.015. Epub 2024 Nov 2.

Abstract

AIM

This study aims to analyze trends in venous thromboembolism (VTE) mortality in the Spanish Autonomous Communities (ACs) from 1999 to 2022, with a focus on identifying regional disparities and informing targeted public health interventions.

METHODS

Age-standardized mortality rates (ASMRs) were calculated using the European standard population as a reference. Joinpoint regression analysis was employed to identify significant changes in mortality trends, and geographical analysis was conducted using Bayesian inference to assess regional variations in mortality risk.

RESULTS

From 1999 to 2022, Spain recorded 59,515 VTE-related deaths, with a higher proportion in women (59.4%) compared to men (40.6%). On a nationwide scale, VTE ASMRs showed a general decline for both men and women, with rates decreasing from 11.0 to 5.1 per 100,000 in men and from 9.2 to 4.4 per 100,000 in women. However, this decline was not uniform across all regions or demographic groups. Notably, mortality rates among younger individuals, particularly men, increased during the study period, highlighting the need for targeted interventions. Analysis revealed significant regional disparities, with higher mortality risks observed in Extremadura, Aragon, Navarre, and Andalusia, particularly for women.

CONCLUSIONS

This study provides valuable insights into the complex landscape of VTE mortality in Spain. While the overall decline in mortality is encouraging, persistent regional disparities and rising rates among younger individuals underscore the need for ongoing surveillance and targeted interventions.

摘要

目的

本研究旨在分析1999年至2022年西班牙自治区静脉血栓栓塞症(VTE)死亡率的趋势,重点是识别地区差异并为有针对性的公共卫生干预提供信息。

方法

以欧洲标准人口为参考计算年龄标准化死亡率(ASMRs)。采用Joinpoint回归分析确定死亡率趋势的显著变化,并使用贝叶斯推断进行地理分析,以评估死亡风险的地区差异。

结果

1999年至2022年,西班牙记录了59515例与VTE相关的死亡病例,女性比例(59.4%)高于男性(40.6%)。在全国范围内,男性和女性的VTE ASMRs总体呈下降趋势,男性每10万人的发病率从11.0降至5.1,女性从9.2降至4.4。然而,这种下降在所有地区或人口群体中并不一致。值得注意的是,在研究期间,年轻个体,尤其是男性的死亡率有所上升,这凸显了有针对性干预的必要性。分析显示存在显著的地区差异,埃斯特雷马杜拉、阿拉贡、纳瓦拉和安达卢西亚的死亡风险较高,尤其是女性。

结论

本研究为西班牙VTE死亡率的复杂情况提供了有价值的见解。虽然死亡率的总体下降令人鼓舞,但持续存在的地区差异以及年轻个体死亡率的上升强调了持续监测和有针对性干预的必要性。

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