Mortality among males with hemophilia: relations with source of medical care. The Hemophilia Surveillance System Project Investigators.
Mortality among males with hemophilia: relations with source of medical care. The Hemophilia Surveillance System Project Investigators.
复制标题
男性血友病患者的死亡率：与医疗来源的关系。
DOI：
10.1182/blood.v96.2.437
复制
发表时间：
2000
期刊：
影响因子：
20.3
通讯作者：
Nancy Wilber
中科院分区：
文献类型：
--
作者：
J. M. Soucie;Rachelle Nuss;B. Evatt;Abdou Abdelhak;Linda Cowan;H. Hill;Marcia H. Kolakoski;Nancy Wilber
虽然血友病患者的死亡风险增加，但没有研究检查医疗护理来源和其他个人特征与死亡率的关系。为了确定死亡率，并确定死亡原因和死亡率的预测因素，我们研究了一个由六个州的监测系统确定的所有血友病男性组成的队列。资料来源于1993-1995年期间与医生、血友病治疗中心（HTC）和其他护理来源联系的病历审查和死亡证明。检查的因素包括年龄、种族、居住州、健康保险类型、医疗保健来源、血友病类型/严重程度、抑制剂的存在、肝脏疾病、HIV感染和AIDS。共对2950名受试者进行了平均2.6年的随访。他们的中位年龄为22岁; 73%为白色，79%患有血友病A，42%患有严重疾病，67%曾接受过HTC。在7575人年（PY）的观察期间，236人死亡-年龄调整死亡率为40.4例死亡/1000 PY; 65%的死亡与HIV相关。除了年龄，与死亡风险增加（相对风险，P值）独立相关的因素如下：艾滋病（33.5，<.001）; HIV感染（4.7，<.001）;肝病（2.4，<.001）;和医疗保险/医疗补助保险（1.4，<.001）。01）。在HTC接受治疗的患者死亡风险显著降低（0.6，.002）。虽然HIV感染和严重肝病的存在仍然是死亡率的强有力预测因素，但在接受HTC医疗护理的血友病患者中，生存率显着提高。（血。2000;96：437-442）
Although persons with hemophilia are known to be at increased risk of death, no studies have examined the source of medical care and other personal characteristics for associations with mortality. To determine death rates and to identify causes of death and predictors of mortality, we studied a cohort comprised of all hemophilic males identified by a six-state surveillance system. Data were obtained by medical record review of contacts with physicians, hemophilia treatment centers (HTCs), and other sources of care during 1993-1995 and from death certificates. Factors examined included age, race, state of residence, health insurance type, medical care source, hemophilia type/severity, presence of inhibitor, liver disease, HIV infection, and AIDS. A total of 2950 subjects were followed for an average of 2.6 years. Their median age was 22 years; 73% were white, 79% had hemophilia A, 42% had severe disease, and 67% had visited an HTC. During 7575 person years (PYs) of observation, 236 persons died-an age-adjusted mortality rate of 40.4 deaths/1000 PYs; 65% of deaths were HIV related. In addition to age, factors independently associated with increased risk of death (relative risk, P value) were the following: AIDS (33.5, <.001); HIV infection (4.7, <.001); liver disease (2.4, <.001); and Medicare/Medicaid insurance (1.4,. 01). Those persons who had received care in an HTC had a significantly decreased risk of death (0.6,.002). Although HIV infection and the presence of severe liver disease remain strong predictors of mortality, survival is significantly greater among hemophilics who receive medical care in HTCs. (Blood. 2000;96:437-442)
DOI：
--
发表时间：
1972
期刊：
--
影响因子：
--
作者：
D. Cox
通讯作者：
D. Cox