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美国老年人中心力衰竭和肺癌相关的死亡率模式:一项20年的分析。

Patterns in mortality associated with heart failure and lung cancer among older adults in the United States: An analysis of 20 years.

作者信息

Ahad Abdul, Fatima Eeshal, Sultan Wania, Nasar Muhammad Haleem, Jamil Adeena, Shakoor Muteia, Ullah Irfan, Alraies M Chadi, Almagal Naeif

机构信息

Department of Physiology, Khyber Medical College, Peshawar, Pakistan.

Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2024 Nov 26;24:200353. doi: 10.1016/j.ijcrp.2024.200353. eCollection 2025 Mar.

Abstract

BACKGROUND

Despite an established association between heart failure (HF) and lung cancer (LC), there is limited evidence available regarding mortality patterns among the older (≥65 years) population in the United States.

METHODS

The mortality data, spanning 1999 to 2019, was surveyed using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database with HF and LC identified as underlying or contributing causes of death. Crude and age-adjusted mortality rates (AAMR) were calculated per 100,000 individuals. Joinpoint regression was applied to establish annual percent changes (APCs) for the trends in years, demographics (sex, race), and geographical regions.

RESULTS

Between 1999 and 2019, the overall AAMR slightly decreased from 13.0 to 11.4. However, the AAMRs significantly increased (APC: 6.37; 95 % CI: 3.39 to 8.23) from 2017 to 2019. Males had double the AAMRs compared to females (overall AAMR: 15.7 vs. 8.0), yet both sexes experienced a final incline in death rates. Among the distinct racial and ethnic groups, non-Hispanic (NH) Whites (11.9) and NH Black/African Americans (10.9) portrayed the highest AAMRs. Patients most commonly died in medical facilities (41.03 %). Geographical disparities were evident with higher AAMRs in non-metropolitan areas (14.3) and the Midwest (12.7). States with the highest fatality involved West Virginia, Oklahoma, Kentucky, Mississippi, and Arkansas.

CONCLUSION

The abrupt rise in overall mortality rates for HF and LC from 2017 to 2019 is noteworthy. A focused analysis of demographic and geographic disparities is warranted to address this emerging trend.

摘要

背景

尽管心力衰竭(HF)与肺癌(LC)之间已确立关联,但关于美国老年(≥65岁)人群死亡率模式的现有证据有限。

方法

利用疾病控制与预防中心的广泛在线流行病学研究数据(CDC WONDER)数据库调查了1999年至2019年的死亡率数据,将HF和LC确定为潜在或促成死亡原因。计算每10万人的粗死亡率和年龄调整死亡率(AAMR)。应用连接点回归来确定年份、人口统计学特征(性别、种族)和地理区域趋势的年度百分比变化(APC)。

结果

1999年至2019年期间,总体AAMR从13.0略有下降至11.4。然而,2017年至2019年期间,AAMR显著上升(APC:6.37;95%置信区间:3.39至8.23)。男性的AAMR是女性的两倍(总体AAMR:15.7对8.0),但两性的死亡率最终都呈上升趋势。在不同的种族和族裔群体中,非西班牙裔(NH)白人(11.9)和NH黑人/非裔美国人(10.9)的AAMR最高。患者最常死于医疗机构(41.03%)。地理差异明显,非大都市地区(14.3)和中西部地区(12.7)的AAMR较高。死亡率最高的州包括西弗吉尼亚州、俄克拉荷马州、肯塔基州、密西西比州和阿肯色州。

结论

2017年至2019年HF和LC总体死亡率的突然上升值得关注。有必要对人口统计学和地理差异进行重点分析,以应对这一新兴趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e60b/11697840/6fdabab526c6/ga1.jpg

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