National Differences in Trends for Heart Failure Hospitalizations by Sex and Race/Ethnicity.
National Differences in Trends for Heart Failure Hospitalizations by Sex and Race/Ethnicity.
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DOI：
10.1161/circoutcomes.116.003552
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发表时间：
2017-07
期刊：
影响因子：
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通讯作者：
Fonarow GC
中科院分区：
文献类型：
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作者：
Ziaeian B;Kominski GF;Ong MK;Mays VM;Brook RH;Fonarow GC
全国心力衰竭（HF）住院率尚未按性别或人种/种族进行适当的年龄标准化。按亚组报告医院利用趋势对于监测人口健康和制定干预措施以消除差异非常重要。使用国家住院患者样本（NIS）估计2002年至2013年期间按性别和种族/民族划分的HF住院的粗率和年龄标准化率。直接标准化被用来将年龄标准化为2000年美国标准人口。报告了亚组之间的相对差异。2002年至2013年，全国年龄调整的HF住院率从526.86/10万下降到364.66/10万，下降了30.8%。虽然所有亚组的住院率都有所下降，但2002年至2013年期间，男性与女性相比的年龄标准化率从20%增加到39%（趋势p =0.002）。2013年，黑人男性的比例为229%（趋势p =0.141），黑人女性为240%（趋势p =0.725），与白人相比，2002年至2013年没有显著变化。2002年，西班牙裔男性的发病率比白人高32%，2013年的差异缩小到4%（趋势p =0.047）。对于西班牙裔女性，2002年的比率比白人高55%，2013年缩小到高8%（趋势p =0.004）。2002年，亚洲/太平洋岛民（PI）男性的发病率比白人低27%，2013年提高到43%（趋势p =0.040）。亚裔/PI女性的住院率在2002年比白人低24%，在2013年改善至低43%（趋势p =0.021）。近十年来，全国HF住院率稳步下降。按性别和人种/种族划分的HF负担和医院利用差异持续存在。需要采取重大的人群健康干预措施，以减少黑人的HF住院负担。需要对西班牙裔和亚裔/PI患者HF住院率改善的解释因素进行评价。
National heart failure (HF) hospitalization rates have not been appropriately age-standardized by sex or race/ethnicity. Reporting hospital utilization trends by subgroup is important for monitoring population health and developing interventions to eliminate disparities. The National Inpatient Sample (NIS) was used to estimate the crude and age-standardized rates of HF hospitalization between 2002 and 2013 by sex and race/ethnicity. Direct standardization was used to age-standardize rates to the 2000 U.S. standard population. Relative differences between subgroups were reported. The national age-adjusted HF hospitalization rate decreased 30.8% from 526.86 to 364.66 per 100,000 between 2002 and 2013. While hospitalizations decreased for all subgroups, the ratio of the age-standardized rate for males compared to females increased from 20% greater to 39% (p-for-trend=0.002) between 2002 and 2013. Black males had a rate that was 229% (p-for-trend=0.141) and black females 240% (p-for-trend=0.725) with reference to whites in 2013 with no significant change between 2002 and 2013. Hispanic males had a rate that was 32% greater in 2002 and the difference narrowed to 4% (p-for-trend=0.047) greater in 2013 relative to whites. For Hispanic females the rate was 55% greater in 2002 and narrowed to 8% greater (p-for-trend=0.004) in 2013 relative to whites. Asian/Pacific Islander (PI) males had a 27% lower rate in 2002 that improved to 43% (p-for-trend=0.040) lower in 2013 relative to whites. For Asian/PI females the hospitalization rate was 24% lower in 2002 and improved to 43% (p-for-trend=0.021) lower in 2013 relative to whites. National HF hospitalization rates have decreased steadily over the recent decade. Disparities in HF burden and hospital utilization by sex and race/ethnicity persist. Significant population health interventions are needed to reduce the HF hospitalization burden among blacks. The evaluation of factors explaining the improvements in the HF hospitalization rates among Hispanics and Asian/PI are needed.