Haywood L J, Ell K, Sobel E, deGuzman M, Blumfield D
Department of Medicine, University of Southern California School of Medicine, Los Angeles.
Ethn Dis. 1993 Summer;3(3):303-14.
We administered the Rose Questionnaire to 1442 black, white, and Latino patients (approximately equal numbers) who sought care for acute chest pain at two medical centers. Of these, 718 subjects were enrolled at a large public hospital serving a low-socioeconomic status population and 724 at a large health maintenance organization hospital serving a middle-class clientele. Using the standard definition of Rose angina, multivariate logistic regression analysis identified five factors that contributed to the relative risk of a positive response: family history of myocardial infarction (2.48), history of peripheral vascular disease (1.41), history of high blood pressure (1.29), history of high cholesterol (1.26), and low-socioeconomic status hospital (0.78). Inquiring about shortness of breath as a substitute for chest pain or an alternative complaint in set one of the Rose Questionnaire did not increase the number of positive responses or differentiate between the socioeconomic groups or race-ethnic subgroups. Having a prior history of self-reported risk factors clearly defined a group with greater likelihood of a positive response to the Rose Questionnaire. Receiving care at a large public hospital (ie, being in a low-socioeconomic status group) was associated with reduced likelihood of having "typical" angina in comparison to receiving care at a health maintenance organization (middle socioeconomic status) for white subjects but not for Latinos and blacks.
我们对1442名黑种人、白种人和拉丁裔患者(人数大致相等)进行了罗斯问卷(Rose Questionnaire)调查,这些患者在两家医疗中心因急性胸痛就诊。其中,718名受试者在一家为社会经济地位较低人群服务的大型公立医院登记,724名在一家为中产阶级客户服务的大型健康维护组织医院登记。采用罗斯心绞痛的标准定义,多因素逻辑回归分析确定了导致阳性反应相对风险的五个因素:心肌梗死家族史(2.48)、外周血管疾病史(1.41)、高血压病史(1.29)、高胆固醇病史(1.26)以及社会经济地位较低的医院(0.78)。在罗斯问卷的第一组中询问呼吸急促以替代胸痛或作为替代主诉,并未增加阳性反应的数量,也未区分社会经济群体或种族亚组。有自我报告的危险因素既往史明确界定了一组对罗斯问卷阳性反应可能性更大的人群。与在健康维护组织(中等社会经济地位)接受治疗相比,白种人在大型公立医院接受治疗(即处于社会经济地位较低群体)与患“典型”心绞痛的可能性降低有关,但拉丁裔和黑种人并非如此。