利用纵向电子健康记录衍生数据，研究老年社区居民的心脏代谢共病与心源性猝死风险

Cardiometabolic multimorbidity and the risk of sudden cardiac death among geriatric community dwellers using longitudinal EHR-derived data.

作者信息

Li Yue, Mei Zihan, Liu Zhengkun, Li Ji, Sun Guolei, Ong Marcus Eng Hock, Chen Jiancheng, Fan Haojun, Cao Chunxia

机构信息

School of Disaster and Emergency Medicine, Tianjin University, Tianjin, China.

College of Management and Economics, Tianjin University, Tianjin, China.

出版信息

Front Endocrinol (Lausanne). 2025 Apr 25;16:1515495. doi: 10.3389/fendo.2025.1515495. eCollection 2025.

DOI:10.3389/fendo.2025.1515495

PMID:40352453

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12061703/

Abstract

BACKGROUND

Cardiometabolic multimorbidity (CMM) has increased globally in recent years, especially among geriatric community dwellers. However, it is currently unclear how SCD risk is impacted by CMM in older adults. This study aimed to examine the associations between CMM and SCD among geriatric community dwellers in a province of China.

METHODS

This study was a retrospective, population-based cohort design based on electronic health records (EHRs) of geriatric community dwellers (≥65 years old) in four towns of Tianjin, China. 55,130 older adults were included in our study. Older adults were categorized into different CMM patterns according to the cardiometabolic disease (CMD) status at baseline. The count of CMDs was also entered as a continuous variable to examine the potential additive effect of CMM on SCD. Cox proportional hazard models were used to evaluate associations between CMM and SCD. The results are expressed as hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

The prevalence of CMM was approximately 25.3% in geriatric community dwellers. Among participants with CMM, hypertension and diabetes was the most prevalent combination (9,379, 17.0%). The highest crude mortality rates for SCD were 7.5 (2.9, 19.1) per 1000 person-years in older adults with hypertension, coronary heart disease, diabetes and stroke (HR, 4.496; 95% CI, 1.696, 11.917), followed by those with hypertension, coronary heart disease, and stroke (HR, 3.290; 95% CI, 1.056, 10.255). The risks of SCD were significantly increased with increasing numbers of CMDs (HR, 1.787; 95% CI, 1.606, 1.987). The demographic, risk factors, serum measures and ECG-adjusted HR for SCD was 1.488 (1.327, 1.668) for geriatric community dwellers with an increasing number of CMDs.

CONCLUSION

The risk of SCD varied by the pattern of CMM, and increased with increasing number of CMM among geriatric community dwellers.

摘要

背景

近年来，心脏代谢共病（CMM）在全球范围内呈上升趋势，尤其是在老年社区居民中。然而，目前尚不清楚CMM如何影响老年人的心源性猝死（SCD）风险。本研究旨在探讨中国某省份老年社区居民中CMM与SCD之间的关联。

方法

本研究采用回顾性、基于人群的队列设计，基于中国天津市四个城镇老年社区居民（≥65岁）的电子健康记录（EHR）。我们的研究纳入了55130名老年人。根据基线时的心脏代谢疾病（CMD）状态，将老年人分为不同的CMM模式。CMD的数量也作为连续变量纳入，以检验CMM对SCD的潜在累加效应。采用Cox比例风险模型评估CMM与SCD之间的关联。结果以风险比（HR）和95%置信区间（CI）表示。

结果

老年社区居民中CMM的患病率约为25.3%。在患有CMM的参与者中，高血压和糖尿病是最常见的组合（9379例，17.0%）。患有高血压、冠心病、糖尿病和中风的老年人中，SCD的最高粗死亡率为每1000人年7.5（2.9，19.1）例（HR，4.496；95%CI，1.696，11.917），其次是患有高血压、冠心病和中风的老年人（HR，3.290；95%CI，1.056，10.255）。SCD风险随着CMD数量的增加而显著增加（HR，1.787；95%CI，1.606，1.987）。对于患有越来越多CMD的老年社区居民，经人口统计学、危险因素、血清指标和心电图调整后的SCD HR为1.488（1.327，1.668）。