SURVEILLANCE OF OUT OF HOSPITAL CHD DEATHS

描述：（改编自研究者摘要）科珀斯克里斯蒂 心脏计划（CCHP）最初于1987年获得资助，并于1992年重新获得资助 对住院的冠心病患者实施监测计划， 心脏病（CHD）发生在女性和男性之间的双种族 墨西哥裔美国人（MA）和非西班牙裔白人（NHW） 25-74居住在科珀斯克里斯蒂（Nueces县），德克萨斯州。中央 在这项冠状动脉监测研究中提出的假设 这四种性别种族的CHD自然史差异 群体，包括糖尿病的作用。病例识别于 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数。 然而，在这方面， 对冠心病导致的院外死亡的研究 这是该监视计划的一部分。 关于这一问题的严重程度和差异，现有数据有限。 根据种族和性别， 特别是从整个社会的角度来看。因此，要有一个 更完整和准确地了解社区冠心病负担， 医院外死亡，以及那些发生在医院，应 追究调查人员已经开始研究外- 由于CHD而导致的医院死亡， 过去两年。在本申请中，要求提供资金， 继续识别、收集数据并验证死亡原因， 住院患者在院外环境中发生的潜在CHD死亡 科珀斯克里斯蒂，德克萨斯州。在本研究项目结束时， 研究人员说，他们应该能够作出有益的贡献， 了解院外冠心病死亡率 以及MA和NHW妇女和男子的社区CHD总死亡率。 拟议的院外冠心病死亡监测的具体目标 研究如下：1）计算经验证院外死亡 在这个双种族社区的冠心病发病率，以检验假设 MA中年龄调整后的院外CHD死亡率较低 男性和女性的NHW; 2）确定糖尿病是否 取代冠心病作为报告的潜在死亡原因更频繁 在MA之间比在NHW之间，并且确定MA和NHW是否 糖尿病死亡者有冠心病、中风和肾衰竭诊断 在多种死亡原因中的记录相似;以及3） 确定急性心肌梗死的总社区死亡率 心肌梗死（AMI）和慢性CHD，以检验MA将 社区AMI和慢性CHD总死亡率高于NHW 结合拟议项目的数据， 正在进行的医院监测项目。

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.