Rural-Urban Differences in Diagnosed Cervical Artery Dissection in New York State.
Rural-Urban Differences in Diagnosed Cervical Artery Dissection in New York State.
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DOI：
10.1159/000521204
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发表时间：
2022
影响因子：
2.9
通讯作者：
Elkind, Mitchell S. V.
中科院分区：
文献类型：
--
作者：
Hunter, Madeleine Dulany;Kulick, Erin R.;Miller, Eliza;Willey, Joshua;Boehme, Amelia K.;Branas, Charles;Elkind, Mitchell S. V.
颈动脉夹层（CeAD）是年轻人中风的主要原因。发病率估计可能受到诊断不足或过度诊断的限制。我们的目的是调查与纽约州（NYS）农村地区相比，城市中心的CeAD诊断是否更高。在这项生态研究中，使用行政代码来识别2009-2014年纽约州全州规划和研究合作系统（SPARCS）中的CeAD排放。农村城市通勤区（RUCA）代码取自美国农业部，包括大都市、小都市、小城镇和农村的分类。负二项模型用于计算RUCA分类与每个邮政编码的夹层数量之间相关性的效应估计值和95%置信限（eCI; 95%CI）。模型根据人群进一步调整。从美国人口普查局获得了1，797个纽约州邮政编码（占纽约州邮政编码的70.7%）的人口信息，其中826个在2009年至2014年期间至少有一次CeAD相关放电。即使在调整人口后，非农村邮政编码也更有可能报告相对于农村地区更多的CeAD病例（大都市效应= 5.00; 95% CI 3.75-6.66;小都市效应3.02; 95% CI 2.16-4.23;小城镇效应2.34; 95% CI 1.58-3.47）。CeAD的诊断与人口密度相关，定义为农村-城市状态。我们的研究结果可能是由于农村地区的诊断不足或随着城市化的增加而过度诊断。
Cervical artery dissection (CeAD) is a leading cause of stroke in young adults. Incidence estimates may be limited by under- or over-diagnosis. We aimed to investigate if CeAD diagnosis would be higher in urban centers compared to rural regions of New York State (NYS). For this ecological study, administrative codes were used to identify CeAD discharges in the NYS Statewide Planning and Research Cooperative System (SPARCS) from 2009-2014. Rural Urban Commuting Area (RUCA) codes were taken from the United States Department of Agriculture and included the classifications metropolitan, micropolitan, small town, and rural. Negative binomial models were used to calculate effect estimates and 95% confidence limits (eß; 95% CI) for the association between RUCA classification and the number of dissections per ZIP code. Models were further adjusted by population. Population information was obtained from the US Census Bureau on 1,797 NYS ZIP codes (70.7% of NYS ZIP codes), 826 of which had at least one CeAD related discharge from 2009-2014. Non-rural ZIP codes were more likely to report more CeAD cases relative to rural areas even after adjusting for population (metropolitan effect= eß 5.00; 95% CI 3.75-6.66; micropolitan effect 3.02; 95% CI 2.16-4.23; small town effect 2.34; 95% CI 1.58-3.47). CeAD diagnosis correlates with population density as defined by rural-urban status. Our results could be due to under-diagnosis in rural areas or over-diagnosis with increasing urbanicity.
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影响因子：
--
作者：
ADAMS, HP;KAPPELLE, LJ;HEFFNER, M
通讯作者：
HEFFNER, M
影响因子：
8.3
作者：
Guillon, B;Berthet, K;Tzourio, C
通讯作者：
Tzourio, C
影响因子：
48
作者：
Markus, Hugh S.;Hayter, Elizabeth;Delcourt, Candice
通讯作者：
Delcourt, Candice
影响因子：
9.9
作者：
Lee, Vivien H.;Brown, Robert D., Jr.;Mokri, Bahram
通讯作者：
Mokri, Bahram
影响因子：
2.9
作者：
Arauz, Antonio;Hoyos, Leticia;Roman, Gustavo
通讯作者：
Roman, Gustavo