Incidence and in-hospital mortality of acute aortic dissection in China: analysis of China Health Insurance Research (CHIRA) Data 2011.
Incidence and in-hospital mortality of acute aortic dissection in China: analysis of China Health Insurance Research (CHIRA) Data 2011.
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DOI：
10.11909/j.issn.1671-5411.2015.05.021
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Wu HY
中科院分区：
文献类型：
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作者：
Xia L;Li JH;Zhao K;Wu HY
急性主动脉夹层是一种早期死亡率很高的灾难性事件，但到目前为止，内地中国还没有关于急性主动脉夹层发病率的数据。本研究的目的是评估中国的AAD发生率，并描述这一血管事件的临床特征、处理和住院结果。我们使用2011年中国医疗保险研究数据(CHIRA数据)，该数据包含2011年1月1日至2011年12月31日期间的所有住院记录(300,886人)，随机抽样3,335,000名受益人(男性1,718,500人，女性1,616,500人)，这些受益人来自内地不同经济地理区域的25个市县。根据I71.0的国际疾病分类第10版(ICD-10)对急性主动脉夹层患者进行鉴定。AAD的预计发病率按公式计算：预计发病率=2.0×(40%×住院率)+60%×住院率。住院率为2.0/10万(65/3325,000，95%CI：1.2~2.8)。年发病率估计为2.8/10,000(95%可信区间：1.9-3.6)，男性高于女性(3.7vs.1.5，P<；0.001)。平均年龄(58.9±13.4)岁。平均住院时间为23±6天，住院死亡率为13.9%(9/65)。我们的研究显示，在中国的内地，AAD的发病率和住院死亡率相对较低，但不容忽视。中国AAD患者的平均年龄低于西方国家的研究报告，而男性与女性的发病率比与其他研究报告的相似。
Acute aortic dissection (AAD) is a catastrophic event with high early mortality rate, but to date, no data on the incidence of AAD in Mainland China is available. This study aimed to estimate the incidence of AAD in China and characterize the clinical profile, management and in-hospital outcomes of this vascular event. We used the China Health Insurance Research Data (the CHIRA Data) 2011 which comprises all inpatient hospital records (300,886) during the period of Jan. 1st 2011 to Dec. 31 2011 of 3,335,000 randomly sampled beneficiaries (1,718,500 men and 1,616,500 women) from 25 cities and counties in different economic-geographic regions of Mainland China. Patients with acute aortic dissection were identified according to International Classification of Disease 10th Revision (ICD-10) of I71.0. The estimated incidence of AAD was calculated using the equation: estimated incidence = 2.0 × (40% × hospital admission rate) + 60% × hospital admission rate. The hospital admission rate was 2.0/100,000 (65/3,325,000, 95% CI: 1.2–2.8). The estimated annual incidence of AAD was 2.8/100,000 (95% CI: 1.9–3.6) and was higher in male than in female (3.7 vs. 1.5, P < 0.001). The mean age was 58.9 ± 13.4 years. During the mean hospital stay of 23 ± 6 days, the overall in-hospital mortality was 13.9% (9/65). Our study showed relatively lower but not negligible incidence and in-hospital mortality of AAD in the mainland of China. The mean age of patients with AAD in Chinese was younger than that reported by researches from west countries, while the male to female incidence ratio is similar to those reported by other studies.