The association between neighborhood socioeconomic status and clinical outcomes among patients 1 year after hospitalization for cardiovascular disease.
The association between neighborhood socioeconomic status and clinical outcomes among patients 1 year after hospitalization for cardiovascular disease.
复制标题
DOI：
10.1007/s10900-013-9666-0
复制
发表时间：
2013-08
影响因子：
5.9
通讯作者：
Aggarwal, Brooke
中科院分区：
文献类型：
--
作者：
Villanueva, Carolina;Aggarwal, Brooke
居住在社会经济地位较低的社区与发病率和死亡率的风险增加有关。很少有研究在纽约市（NYC）接受治疗的人群中检查心血管疾病（CVD）结局的相关性。本研究的目的是确定社区水平的贫困和一年的临床结果（再住院和/或死亡）之间的关系住院CVD患者。从2009年11月至2010年9月在纽约市一所大学医学中心住院的连续患者中收集了1年时再住院和/或死亡的数据。纽约市居民总数为2198人。2000年美国人口普查的邮政编码数据被用来量化社区SES到贫困的五分之一（Q1=最低贫困到Q5=最高贫困）。单变量分析用于确定邻里贫困与基线特征和合并症之间的关系。逻辑回归分析用于计算贫困五分位数与一年内再住院/死亡之间关联的比值比。55%的参与者经历了不良后果。Q5的参与者（9%）更有可能是女性（比值比[OR]= 0.49，95%置信区间[CI] 0.33-0.73），年轻（OR= 0.50，95% CI 0.34-0.74）、少数民族（OR= 18.24，95% CI 11.12=29.23）、无医疗保险（OR= 4.79，95% CI 2.92-7.50）。生活在Q5与合并症（包括糖尿病和高血压）的增加显著相关，但不是一年后再住院/死亡的显著预测因素。在因CVD住院的患者中，较高的贫困社区居住与更高的合并症患病率显著相关，但与再住院和/或死亡无关。这些社区应该提供负担得起的、可获得的资源，以降低心血管疾病和这些合并症的风险。
Residing in lower socioeconomic status neighborhoods is associated with increased risk of morbidity and mortality. Few studies have examined this association for cardiovascular disease (CVD) outcomes in a treated population in New York City (NYC). The purpose of this study was to determine the relationship between neighborhood level poverty and one-year clinical outcomes (rehospitalization and/or death) among hospitalized patients with CVD. Data on rehospitalization and/or death at one-year were collected from consecutive patients admitted at a university medical center in NYC from November 2009 to September 2010. NYC residents totaled 2,198. U.S. Census 2000 zip code data was used to quantify neighborhood SES into quintiles of poverty (Q1=lowest poverty to Q5=highest poverty). Univariate analyses were used to determine associations between neighborhood poverty and baseline characteristics and comorbidities. A logistic regression analysis was used to calculate odds ratios for the association between quintiles of poverty and rehospitalization/death at one year. Fifty-five percent of participants experienced adverse outcomes. Participants in Q5 (9%) were more likely to be female (odds ratio [OR]=0.49,95% confidence interval [CI] 0.33–0.73), younger (OR=0.50,95% CI 0.34–0.74), of minority race/ethnicity (OR=18.24,95% CI 11.12=29.23), and have no health insurance (OR=4.79,95% CI 2.92–7.50). Living in Q5 was significantly associated with increased comorbidities, including diabetes mellitus and hypertension, but was not a significant predictor of rehospitalization/death at one year. Among patients hospitalized with CVD, higher poverty neighborhood residence was significantly associated with a greater prevalence of comorbidities, but not of rehospitalization and/or death. Affordable, accessible resources targeted at reducing the risk of developing CVD and these comorbidities should be available in these communities.
登录
查看更多内容
影响因子：
37.8
作者：
Roger VL;Go AS;Lloyd-Jones DM;Benjamin EJ;Berry JD;Borden WB;Bravata DM;Dai S;Ford ES;Fox CS;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Makuc DM;Marcus GM;Marelli A;Matchar DB;Moy CS;Mozaffarian D;Mussolino ME;Nichol G;Paynter NP;Soliman EZ;Sorlie PD;Sotoodehnia N;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
影响因子：
4.5
作者：
Gary-Webb TL;Baptiste-Roberts K;Pham L;Wesche-Thobaben J;Patricio J;Pi-Sunyer FX;Brown AF;Jones-Corneille L;Brancati FL;Look AHEAD Research Group
通讯作者：
Look AHEAD Research Group
影响因子：
4.5
作者：
Pedigo A;Aldrich T;Odoi A
通讯作者：
Odoi A
DOI：
10.1007/s11524-006-9093-y
发表时间：
2006-11-01
影响因子：
6.6
作者：
Fang, Jing;Negassa, Abdissa;Alderman, Michael H.
通讯作者：
Alderman, Michael H.
影响因子：
4.9
作者：
Peled R;Reuveni H;Pliskin JS;Benenson I;Hatna E;Tal A
通讯作者：
Tal A