The consortium to establish a registry for Alzheimer's disease (CERAD) .13. Obtaining autopsy in Alzheimer's disease
The consortium to establish a registry for Alzheimer's disease (CERAD) .13. Obtaining autopsy in Alzheimer's disease
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DOI：
10.1212/wnl.46.1.142
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发表时间：
1996-01-01
期刊：
影响因子：
9.9
通讯作者：
Harrell, LE
中科院分区：
文献类型：
--
作者：
Fillenbaum, GG;Huber, MS;Harrell, LE
虽然美国的尸检率一直在稳步下降，但脑尸检以确认阿尔茨海默病（AD）的必要性仍然存在。在24 CERAD的308例连续死亡的AD患者中，（建立阿尔茨海默病登记处联盟）网站，167（54%）进行了尸检; 141例（46%）未进行尸检，尸检组和非尸检组在性别上具有可比性（男性，57.5%对49.7%）、婚姻状况（已婚，69.3%对67.1%）、入组时年龄（73岁对74岁）、死亡时年龄（76岁对77岁）和入组时疾病分期（轻度，46%对43%）。然而，尸检的病人明显更可能是白色（94.5%对82.1%），接受更好的教育（13.1 vs 11.3年），参与研究时间更长（平均3.3年对2.6年），并且AD总持续时间更长在24个CERAD研究中心中，13个研究中心通过指定一名工作人员进行尸检并提供免费尸检和交通工具来强调尸检的重要性; 11个研究中心没有这样做。Logistic回归分析显示，白色人种（优势比[OR] = 2.74; 95%可信区间[CI] = 1.10-6.83）、受教育程度高（OR = 1.12; 95% CI = 1.04-1.21）和重视尸检（OR = 4.69; 95% CI = 2.67-8.25）是仅有的显著因素。虽然种族和教育很重要，但当研究中心为此投入资源时，尸检更有可能获得。
Although autopsy rates in the United States have been decreasing steadily, the necessity for brain autopsy to confirm Alzheimer's disease (AD) remains. Of 308 consecutively deceased AD patients at 24 CERAD (Consortium to Establish a Registry for Alzheimer's Disease) sites, 167 (54%) were autopsied; 141 (46%) were not, The autopsied and nonautopsied groups were comparable in gender (men, 57.5% versus 49.7%), marital status (married, 69.3% versus 67.1%), age at entry (73 versus 74 years), age at death (76 versus 77 years), and stage of disease at entry (mild, 46% versus 43%). However, the autopsied patients were significantly more likely to be white (94.5% versus 82.1%), to be better educated (13.1 versus 11.3 years), to have been in the study longer (mean, 3.3 versus 2.6 years), and to have had longer total duration of AD (8.1 versus 6.7 years), Of the 24 CERAD sites, 13 stressed the importance of autopsy by dedicating a staff member to seek autopsy and by providing free autopsy and transportation; 11 did not. Logistic regression analysis showed that white race (odds ratio [OR] = 2.74; 95% confidence interval [CI] = 1.10-6.83), increased education (OR = 1.12; 95% CI = 1.04-1.21), and emphasis on autopsy (OR = 4.69; 95% CI = 2.67-8.25) were the only significant factors. Although race and education were important, autopsy was more likely to be obtained when sites dedicated resources to this endeavor.