Mortality Among Adults With Intellectual Disability in England: Comparisons With the General Population
Mortality Among Adults With Intellectual Disability in England: Comparisons With the General Population
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DOI：
10.2105/ajph.2016.303240
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发表时间：
2016-08-01
影响因子：
12.7
通讯作者：
Cook, Derek G.
中科院分区：
文献类型：
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作者：
Hosking, Fay J.;Carey, Iain M.;Cook, Derek G.
目标。描述英格兰智力残疾成年人的死亡率，并与普通人群进行比较。我们从2009年到2013年进行了一项队列研究，使用了来自343个一般实践的数据。有智力障碍的成年人(n=16 666；656例死亡)与年龄、性别和实践相匹配的对照组(n=113 562；1358例死亡)进行了比较。有智力障碍的成年人死亡率高于对照组(危险比[HR]=3.6；95%可信区间[CI]=3.3，3.9)。在调整了共病、吸烟和剥夺后，这种风险仍然很高(HR=3.1；95%CI=2.7，3.4)；在患有智力残疾和唐氏综合症或癫痫的成年人中，这一风险甚至更高。37.0%的智力残疾成人死亡被归类为可接受卫生保健干预，而普通人群的这一比例为22.5%(HR=5.9；95%CI=5.1，6.8)。与普通人群相比，智力残疾成年人的死亡率明显上升，三分之一以上的死亡可能要接受医疗保健干预。这一死亡率差距表明，需要改善智障人士获得医疗保健的机会和质量。
Objectives. To describe mortality among adults with intellectual disability in England in comparison with the general population.Methods. We conducted a cohort study from 2009 to 2013 using data from 343 general practices. Adults with intellectual disability (n = 16 666; 656 deaths) were compared with age-, gender-, and practice-matched controls (n = 113 562; 1358 deaths).Results. Adults with intellectual disability had higher mortality rates than controls (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 3.3, 3.9). This risk remained high after adjustment for comorbidity, smoking, and deprivation (HR = 3.1; 95% CI = 2.7, 3.4); it was even higher among adults with intellectual disability and Down syndrome or epilepsy. A total of 37.0% of all deaths among adults with intellectual disability were classified as being amenable to health care intervention, compared with 22.5% in the general population (HR = 5.9; 95% CI = 5.1, 6.8).Conclusions. Mortality among adults with intellectual disability is markedly elevated in comparison with the general population, with more than a third of deaths potentially amenable to health care interventions. This mortality disparity suggests the need to improve access to, and quality of, health care among people with intellectual disability.