Improving the comparability of diabetes mortality statistics in the US and Mexico
Improving the comparability of diabetes mortality statistics in the US and Mexico
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DOI：
10.2337/dc07-1370
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发表时间：
2008-03-01
期刊：
影响因子：
16.2
通讯作者：
Ezzati, Majid
中科院分区：
文献类型：
--
作者：
Murray, Christopher J. L.;Dias, Rodrigo H.;Ezzati, Majid
目的-本研究的目的是增加跨国家的可比性糖尿病死亡率统计相关的美国和墨西哥研究设计和方法-我们使用多项逻辑回归估计个人和社区因素对死亡的影响，其中糖尿病被记录为多个促成死亡的原因之一（MCD）被分配给糖尿病作为潜在的死亡原因（UCD）与分配到心血管，其他非传染性或传染性疾病。我们使用该模型来估计国家一级的糖尿病死亡率，标准化的个人和社区factor.RESULTS -糖尿病死亡的MCD之一，更有可能被分配到心血管疾病的原因，如果他们发生在医院或如果进行尸检，如果死者来自国家具有较高的BMI和收缩压，更多的教育，或有保险。调整个人和社区水平的因素大大增加了糖尿病作为UCD和糖尿病作为MCD死亡率之一的跨州相关性。这一调整还使美国的直接糖尿病死亡人数减少了10%，墨西哥减少了24%。在美国，糖尿病死亡率在犹他州、新墨西哥州、新泽西和路易斯安那州下降最多，在加州和夏威夷增加。在墨西哥，调整后的糖尿病死亡人数比在所有州观察到的人数少3- 34%。另外126，300人死于缺血性心脏病和中风，在美国和19，497在墨西哥归因于高blood glucose.CONCLUSIONS -有必要提高糖尿病死因分配的可比性，特别是与心血管疾病相关。
OBJECTIVE - The aim of this study was to increase the cross-state comparability of diabetes mortality statistics related in the U.S. and Mexico.RESEARCH DESIGN AND METHODS - We used multinomial logistic regression to estimate the effects of individual and community factors on a death for which diabetes was recorded as one of the multiple contributing causes of death (MCD) being assigned to diabetes as the underlying cause of death (UCD) versus assignment to cardiovascular, other noncommunicable, or communicable diseases. We used the model to estimate state-level diabetes death rates that are standardized in the individual and community factors.RESULTS - Deaths with diabetes as one of the MCD were more likely to be assigned to cardiovascular causes as the UCD if they occurred in hospitals or if an autopsy was performed and if the decedents were from states with higher BMI and systolic blood pressure, were more educated, or had insurance. Adjusting for individual- and community-level factors substantially increased the cross-state correlation of diabetes as the UCD and diabetes as one of the MCD mortality rates. The adjustment also reduced the number of direct diabetes deaths by 10% in the U.S. and by 24% in Mexico. In the U.S., deaths with diabetes as the UCD declined most in Utah, New Mexico, New Jersey, and Louisiana and increased in California and Hawaii. In Mexico, the numbers of adjusted diabetes deaths were smaller than those observed in all states by 3-34%. An additional 126,300 deaths due to ischemic heart disease and stroke in the U.S. and 19,497 in Mexico were attributable to high blood glucose.CONCLUSIONS - There is a need to improve the comparability of diabetes cause-of-death assignment, especially in relation to cardiovascular diseases.