文摘
摘要目的:我们旨在确定小区的劣势与贫穷有关结果脑出血后(我)。
背景:社区劣势独特捕获许多社会和环境风险。有越来越多的证据表明社会决定因素不同的健康状况。
设计/方法:我们进行了一个嵌套的研究在一个正在进行的纵向研究,前瞻性地遵循脑损伤患者在康涅狄格最大的医疗体系。嵌套的研究包括我幸存者和评价社区剥夺剥夺使用面积指数(ADI),公开可用指标排名社区的劣势基于许多因素。病人被给予一个ADI tertile名称:低,中间,和高不足。最初我严重程度定义与gc的承认。结果是评估通过放电和6个月post-ICH改良Rankin规模(夫人),一分为二,0 - 3(结果)和4 - 6(可怜的结果)。我们使用卡方测试和未经调整和调整协会多变量逻辑回归分析,分别。
结果:687注册我的病人,518(平均年龄67,47.5%为女性,19%是黑人,8%的西班牙裔)有9-digit你和结果数据。附近的劣势与入学GCS无关(p = 0.59)或放电夫人(p = 0.95)。出院后,然而,在6个月糟糕的结果的风险为28%,44%,47%,患者在社区低,中间,和高的劣势(未调整p = 0.02)。多变量分析调整了潜在的混杂因素证实这些结果:low-disadvantage社区相比,那些生活在社区受过中等和高等缺点有52%(或1.52,95%可信区间0.76 - -3.08)和89%(-3.94或1.89,95% ci 0.91)情况糟糕的风险更高(test-for-trend p = 0.01)。
结论:我患者参与急性脑损伤的前瞻性研究,提高社区的劣势与风险更高的可怜的结果持续post-ICH但不承认或放电的临床状态。这些结果表明,众多因素被ADI影响这些受试者的复杂的终止进化。
披露:Kim没有披露。Kitlen女士没有披露。Torres-Lopez先生没有披露。博士已经收到我们意识到个人的薪酬在500 - 4999美元的范围作为顾问罗盘座伙伴。Renedo博士没有披露。阿迈女士没有披露。没有披露jonkleinberg女士。呸女士已经收到个人薪酬在500 - 4999美元的范围为斜纹疗法作为顾问。Kampp先生没有披露。莎拉Jasak没有披露。 Dr. Sansing has nothing to disclose. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
