SURVEILLANCE OF OUT OF HOSPITAL CHD DEATHS

描述：(改编自调查人员摘要)《克里斯蒂文集》 心脏计划(CCHP)最初于1987年获得资助，并于1992年续签 实施冠心病住院病例监测计划 心脏病(CHD)发生在两个民族的女性和男性之间 墨西哥裔美国人(MA)和非西班牙裔白人(NHW)年龄 25-74居住在德克萨斯州的科珀斯克里斯蒂(Nueces县)。中环 在这项冠状动脉监测研究中提出的假设涉及 不同性别、不同民族冠心病自然史的差异 群体，包括糖尿病的作用。对案件进行了鉴定 在定义的类别内完全确定的基础 社区居民冠心病住院病例分析。然而， 关于因冠心病导致的院外死亡的研究并不是 作为这一监视计划活动的一部分。 关于大小和差异的数据是有限的 在按种族和性别划分的冠心病院外死亡人数中， 特别是从整个社区的角度来看。因此，要有一个 更全面、更准确地了解冠心病的社区负担， 院外死亡和院内死亡应 被调查。调查人员已经开始了对外滩的研究 因冠心病住院死亡，从疾病预防控制中心获得资金 过去两年。在本申请中，请拨资金以 继续确定、收集数据和验证以下人员的死因 发生在居民院外环境中的潜在冠心病死亡 得克萨斯州科珀斯克里斯蒂。在这项研究项目结束时， 调查人员表示，他们应该能够做出有益的贡献 对两种冠心病院外死亡情况的了解 以及MA和NHW男女社区冠心病总死亡率。 建议的院外冠心病死亡监测的具体目标 研究内容如下：1)计算验证的院外死亡人数 这个双民族社区的冠心病发病率，以检验这一假说 在MA中，年龄调整后的院外冠心病死亡率较低 男性和女性的NHW；2)确定糖尿病 更频繁地取代CHD成为报告的潜在死因 在MA之间比在NHW之间并确定MA和NHW是否 糖尿病患者有冠心病、中风和肾功能衰竭的诊断。 在多种死因中记录的类似；以及3) 确定急性心肌梗死的社区总死亡率 心肌梗死(AMI)和慢性CHD，以检验MA将 社区总急性心肌梗死和慢性冠心病死亡率高于健康护理中心 通过将拟议项目的数据和 正在进行的以医院为基础的监测项目。

DESCRIPTION: (Adapted from Investigator's Abstract) The Corpus Christi Heart Project (CCHP) was originally funded in 1987 and renewed in 1992 to implement a surveillance program for hospitalized cases of coronary heart disease (CHD) occurring among women and men in the biethnic population of Mexican-Americans (MA) and non-Hispanic whites (NHW) ages 25-74 residing in Corpus Christi (Nueces County), Texas. The central hypotheses posed in this coronary surveillance study concerned differences in the natural history of CHD in these four sex-ethnic groups, including the role of diabetes. Case identification was made on the basis of complete ascertainment within defined categories of hospitalized cases of CHD occurring among community residents. However, the study of out-of-hospital deaths due to coronary disease was not carried out as part of the activities of this surveillance program. Limited data are available concerning the magnitude of and differences in out-of-hospital deaths due to CHD according to ethnicity and sex, particularly from a community-wide perspective. Therefore, to have a more complete and accurate picture of the community burden from CHD, out-of-hospital deaths, as well as those occurring in-hospital, should be investigated. The investigators have begun the study of out-of- hospital deaths due to CHD with funds obtained from the CDC over the past 2 years. In the present application, funds are requested to continue to identify, collect data, and validate cause of death for potential CHD deaths that occur in out-of-hospital settings for residents of Corpus Christi, Texas. By the end of this research project, the investigators state that they should be able to contribute useful information to the understanding of both out-of-hospital CHD mortality and total community CHD mortality among MA and NHW women and men. The specific aims of the proposed out-of-hospital CHD death surveillance study are as follow: 1) to calculate validated out-of-hospital death rates for CHD in this biethnic community in order to test the hypothesis that age-adjusted, out-of-hospital CHD death rates are lower among MA than among NHW for both men and women; 2) to determine whether diabetes displaces CHD as the reported underlying cause of death more frequently among MA than among NHW and to determine whether or not MA and NHW decedents with diabetes have CHD, stroke, and renal failure diagnoses recorded among the multiple causes of death similarly; and 3) to determine the total community mortality rates from acute myocardial infarction (AMI) and chronic CHD to test the hypothesis that MA will have higher total community AMI and chronic CHD mortality rates than NHW for both women and men by combining data from the proposed project and the ongoing hospital-based surveillance project.