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Song X, Tong Y, Xian F, Luo Y, Tong R. Predicting 1 year readmission for heart failure: A comparative study of machine learning and the LACE index. ESC Heart Fail 2024. [PMID: 38778700 DOI: 10.1002/ehf2.14855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/29/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
AIMS There is a lack of tools for accurately identifying the risk of readmission for heart failure in elderly patients with arrhythmia. The aim of this study was to establish and compare the performance of the LACE [length of stay ('L'), acute (emergent) admission ('A'), Charlson comorbidity index ('C') and visits to the emergency department during the previous 6 months ('E')] index and machine learning in predicting 1 year readmission for heart failure in elderly patients with arrhythmia. METHODS Elderly patients with arrhythmia who were hospitalized at Sichuan Provincial People's Hospital between 1 June 2018 and 31 May 2020 were enrolled. The LACE index was calculated for each patient, and the area under the receiver operating characteristic curve (AUROC) was calculated. Six machine learning algorithms, combined with three variable selection methods and clinically relevant features available at the time of hospital discharge, were used to develop machine learning models. AUROC and area under the precision-recall curve (AUPRC) were used to assess discrimination. Shapley additive explanations (SHAP) analysis was used to explain the contributions of the features. RESULTS A total of 523 patients were enrolled, and 108 patients experienced 1 year hospital readmission for heart failure. The AUROC of the LACE index was 0.5886. The complete machine learning model had the best predictive performance, with an AUROC of 0.7571 and an AUPRC of 0.4096. The most important predictors for 1 year readmission were educational level, total triiodothyronine (TT3), aspartate aminotransferase/alanine aminotransferase (AST/ALT), number of medications (NOM) and triglyceride (TG) level. CONCLUSIONS Compared with the LACE index, the machine learning model can accurately identify the risk of 1 year readmission for heart failure in elderly patients with arrhythmia.
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Affiliation(s)
- Xuewu Song
- Department of Pharmacy, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yitong Tong
- Chengdu Second People's Hospital, Chengdu, China
| | - Feng Xian
- Department of Oncology, Nanchong Central Hospital, the Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Yi Luo
- Department of Pharmacy, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Rongsheng Tong
- Department of Pharmacy, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Bermon A, Trejo-Valdivia B, Molina Castaño CF, Segura AM, Serrano NC. Time-Dependent Risk for Recurrence in Survivors of Major Adverse Cardiovascular Events. Cureus 2024; 16:e59366. [PMID: 38817508 PMCID: PMC11138715 DOI: 10.7759/cureus.59366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION The prevalence of the population with a history of an occlusive cardiovascular event has been increasing in recent years, which means that a large number of patients will have a higher risk of presenting a fatal recurrence. The aim is to determine variables associated with time-to-recurrent cardiovascular events and analyze how changes in low-density lipoprotein cholesterol (LDL-C) levels during follow-up may be associated with this time-to-event. MATERIALS AND METHODS This is a prospective observational cohort study of 727 adults with a history of at least one occlusive cardiovascular event recruited at a referral hospital in northeastern Colombia. Data from a follow-up period of a maximum of 33 months (median 26 months) (one death) were used to define how clinical and sociodemographic variables impact the recurrence of major adverse cardiovascular events (MACE). Analyses were performed based on proportional hazard models and time-dependent hazard models. RESULTS Upon enrollment, 215 (30%) of the participants reported experiencing their most recent cardiovascular event within the preceding year. After two years, the recurrence rate was 12.38% (90/727). The risk of recurrence before two years was 3.9% (95% CI 2.7-5.6). In the multiple models, the presence of severe depression gives a Hazard Ratio of 8.25 (95% CI 2.98-22.86) and LDL ≥120 md/dl Hazard Ratio of 2.12 (95% CI 1.2 -3.9). It was found that LDL >120 mg/dl maintained over time increases the chances of recurrence by 1.7% (Hazard Ratio: 1.017, 95% CI 0.008-0.025). CONCLUSIONS The present study allows us to identify a profile of patients who should be treated promptly in an interdisciplinary manner to avoid recurrences of coronary events.
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Affiliation(s)
- Anderson Bermon
- Centro de Investigaciones, Fundación Cardiovascular de Colombia, Bucaramanga, COL
- Escuela de graduados, Universidad CES, Medellín, COL
| | - Belem Trejo-Valdivia
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, MEX
| | - Carlos Federico Molina Castaño
- Epidemiology, Tecnológico de Antioquia Institución Universitaria, Medellin, COL
- Escuela de graduados, Universidad CES, Medellín, COL
| | | | - Norma C Serrano
- Centro de Investigaciones, Fundación Cardiovascular de Colombia, Bucaramanga, COL
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Bae EH, Lim SY, Yang EM, Oh TR, Choi HS, Kim CS, Ma SK, Kim B, Han KD, Kim SW. The effects of socioeconomic status on major adverse cardiovascular events: a nationwide population-based cohort study. Kidney Res Clin Pract 2023; 42:229-242. [PMID: 37037483 PMCID: PMC10085725 DOI: 10.23876/j.krcp.21.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/28/2022] [Indexed: 04/03/2023] Open
Abstract
Background: Although multiple factors influence the risk of major adverse cardiovascular events (MACE), the effects of socioeconomic status on MACE in the presence and absence of renal dysfunction (RD) have not been comprehensively explored in Korea. Methods: We examined the effects of socioeconomic status on MACE in individuals with and without RD. The data of 44,473 Koreans from 2008 to 2017 were obtained from the Health Care Big Data Platform of the Ministry of Health and Welfare in Korea. Their socioeconomic status was assessed using a socioeconomic score (SES) based on marital status, education, household income, and occupation. The incidence of myocardial infarction (MI), stroke, and death was compared according to SES level (0–4). Multiple linear regression analysis was used to evaluate the hazard ratios and 95% confidence intervals for outcomes based on participant SES. Results: MI risk was only affected by education level. The participants’ income, education, and SES affected their stroke risk, whereas death was associated with all four socioeconomic factors. The incidence of stroke and death increased as SES worsened (from 0 to 4). SES was positively related to risk of stroke and death in participants without RD. SES did not affect MI, stroke, or death in participants with RD. Conclusion: A low socioeconomic status is associated with risk of stroke and death, especially in individuals without RD.
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Affiliation(s)
- Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sang Yup Lim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Eun Mi Yang
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
- Correspondence: Kyung-Do Han Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 06978, Republic of Korea. E-mail:
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
- Soo Wan Kim Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Dong-gu, Gwangju 61469, Republic of Korea. E-mail:
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The Effect of Neighborhood Deprivation on Mortality in Newly Diagnosed Diabetes Patients: A Countrywide Population-Based Korean Retrospective Cohort Study, 2002-2013. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074324. [PMID: 35410005 PMCID: PMC8998590 DOI: 10.3390/ijerph19074324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022]
Abstract
Background: Neighborhood environmental factors along with individual factors are beginning to make a mark as factors which influence individual health outcomes. The goal of this study is to look at the combined impact of individual and neighborhood socioeconomic status on all-cause mortality in diabetic patients who have just been diagnosed. Methods: The Korean National Health Insurance (2002–2013) was employed in this cohort research, which used a stratified random sample. During the years 2003–2006, a total of 15,882 individuals who were newly diagnosed with diabetes and using oral disease-controlling medication were included in the study. Individual income and neighborhood deprivation index were used to examine the combined effect on all-cause mortality. The frailty model was performed using Cox’s proportional hazard regression. Results: During the study period, 28.3 percent (n = 4493) of the 15,882 eligible individuals died. In a Cox regression analysis after adjusting for all covariates, with advantaged and disadvantaged neighborhoods classified according to individual household income, the adjusted HR for patients living in a disadvantaged area was higher compared to patients living in an advantaged area in patients with middle income, compared to the reference group (a high income within an advantaged neighborhood) (HR, 1.22; 95% CI, 1.09–1.35; HR, 1.13; 95% CI, 1.02–1.25, respectively). The adjusted HR for patients with low income who lived in a disadvantaged location was greater than for patients who lived in an advantaged area (HR, 1.34; 95% CI, 1.18–1.53 vs. HR, 1.28; 95% CI, 1.14–1.49). Conclusions: Individual SES has a greater impact on all-cause mortality among diabetic patients when they live in a low-income neighborhood.
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Barreto J, Silva JCQE, Sposito AC, Carvalho LS. The Impact of Education on All-cause Mortality Following St-Segment Elevation Myocardial Infarction (STEMI): Results from the Brazilian Heart Study. Arq Bras Cardiol 2021; 117:5-12. [PMID: 34320060 PMCID: PMC8294733 DOI: 10.36660/abc.20190854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/16/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood. OBJECTIVE To investigate whether schooling stands as an independent risk factor for mortality in STEMI patients. METHODS STEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and >10 years). Groups were compared by student's t test for continuous variables and qui-square for categorical. Incidence of all-cause mortality was compared with Kaplan-Meyer with Cox regression adjusted by age, gender, and GRACE score. Values of p < 0.05 were considered significant. SPSS21.0 was used for all analysis. RESULTS The mean schooling duration was 6.63±4.94 years. During the follow-up period (mean: 21 months; up to 6.8 years), 83 patients died (cumulative mortality of 15%). Mortality rate was higher among the lowest quartile compared to those in the highest quartile [18.5 vs 6.8%; HR 2.725 (95% CI: 1.27-5.83; p=0.01)]. In multivariate analysis, low schooling has lost statistical significance for all-cause mortality after adjustment for age and gender, with HR of 1.305 (95% CI: 0.538-3.16; p=0.556), and after adjustment by GRACE score with an HR of 1.767 (95% CI: .797-3.91; p=0.161). CONCLUSION Low schooling was not an independent risk factor for mortality in STEMI patients.
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Affiliation(s)
- Joaquim Barreto
- Universidade Estadual de Campinas (UNICAMP) - Laboratório de Aterosclerose e Biologia Vascular (Aterolab), Campinas, SP - Brasil
| | | | - Andrei C Sposito
- Universidade Estadual de Campinas (UNICAMP) - Laboratório de Aterosclerose e Biologia Vascular (Aterolab), Campinas, SP - Brasil
| | - Luiz Sergio Carvalho
- Universidade Estadual de Campinas (UNICAMP) - Laboratório de Aterosclerose e Biologia Vascular (Aterolab), Campinas, SP - Brasil
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de Abreu SLL, de Abreu JDMF, Branco MDRFC, dos Santos AM. In- and Out-of-Hospital Deaths by Acute Myocardial Infarction in Brazilian State Capitals. Arq Bras Cardiol 2021; 117:319-326. [PMID: 34495227 PMCID: PMC8395787 DOI: 10.36660/abc.20200043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/21/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is the main cause of death in Brazil and the world. Approximately half of these deaths occur outside the hospital. OBJECTIVES To analyze the distribution, temporal evolution, and sociodemographic characteristics (SDC) of in- and out-of-hospital deaths by AMI in Brazilian state capitals and their relationship with municipal development indicators (MDI). METHODS This is an ecological study of the number of deaths due to AMI reported annually by the 27 Brazilian state capitals from 2007 to 2016; these were divided into 2 groups: in-hospital (H) and out-of-hospital (OH). We evaluated the temporal evolution of mortality rates in each group and differences in SDC. Negative binomial regression models were used to compare the temporal evolution of the number of deaths in each group with the following variables: residing in the South/Southeast regions (S/SE), municipal human development index (MHDI), Gini coefficient, and expected years of schooling (EYS). We considered p-values<0.05 as statisticallysignificant. RESULTS The OH mortality rate increased with time for all state capitals. All studied SDC were different between groups (p<0.001). In the OH group, most deaths were of men and patients aged 80 years or older and not married. S/SE increased the incidence of OH deaths (incidence rate ratio [IRR]=2.84; 95% confidence interval [CI]=1.67-4.85), while higher EYS reduced it (IRR=0.86; 95% CI=0.77-0.97). In the H group, higher MHDI reduced the incidence of deaths (IRR=0.44; 95% CI=0.33-0.58), while higher EYS increased it (IRR=1.09; 95% CI=1.03-1.15). CONCLUSIONS In- and out-of-hospital deaths due to AMI in Brazilian state capitals were influenced by MDI, presented sociodemographic differences and a progressive increase in out-of-hospital occurrences.
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Affiliation(s)
- Sterffeson Lamare Lucena de Abreu
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilHospital Universitário da Universidade Federal do Maranhão, São Luís, MA - Brasil
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Joana D’Arc Matos França de Abreu
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilHospital Universitário da Universidade Federal do Maranhão, São Luís, MA - Brasil
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoPós Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão - Pós Graduação em Saúde Coletiva, São Luís, MA - Brasil
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Tetzlaff J, Geyer S, Westhoff-Bleck M, Sperlich S, Epping J, Tetzlaff F. Social inequalities in mild and severe myocardial infarction: how large is the gap in health expectancies? BMC Public Health 2021; 21:259. [PMID: 33526035 PMCID: PMC7852180 DOI: 10.1186/s12889-021-10236-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (MI) remains a frequent health event and a major contributor to long-term impairments globally. So far, research on social inequalities in MI incidence and mortality with respect to MI severity is limited. Furthermore, evidence is lacking on disparities in the length of life affected by MI. This study investigates social inequalities in MI incidence and mortality as well as in life years free of MI and affected by the consequences of mild or severe MI. METHODS The study is based on data of a large German statutory health insurance provider covering the years 2008 to 2017 (N = 1,253,083). Income inequalities in MI incidence and mortality risks and in life years with mild or severe MI and without MI were analysed using multistate analyses. The assessment of MI severity is based on diagnosed heart failure causing physical limitations. RESULTS During the study period a total of 39,832 mild MI, 22,844 severe MI, 276,582 deaths without MI, 15,120 deaths after mild MI and 16,495 deaths after severe MI occurred. Clear inequalities were found in MI incidence and mortality, which were strongest among men and in severe MI incidence. Moreover, substantial inequalities were found in life years free of MI in both genders to the disadvantage of those with low incomes and increased life years after mild MI in men with higher incomes. Life years after severe MI were similar across income groups. CONCLUSIONS Social inequalities in MI incidence and mortality risks led to clear disparities in the length of life free of MI with men with low incomes being most disadvantaged. Our findings stress the importance of primary and secondary prevention focusing especially on socially disadvantaged groups.
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Affiliation(s)
- Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany.
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | | | | | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Hanover, Germany
| | - Fabian Tetzlaff
- Institute for General Practice, Hannover Medical School, Hanover, Germany
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Huo X, Khera R, Zhang L, Herrin J, Bai X, Wang Q, Lu Y, Nasir K, Hu S, Li J, Li X, Zheng X, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Education level and outcomes after acute myocardial infarction in China. Heart 2019; 105:946-952. [PMID: 30661037 PMCID: PMC6582708 DOI: 10.1136/heartjnl-2018-313752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/25/2018] [Accepted: 11/30/2018] [Indexed: 11/13/2022] Open
Abstract
Objective To assess the association between educational attainment and acute myocardial infarction (AMI) outcomes in China to inform future healthcare interventions. Methods We used data from the China Patient-centred Evaluative Assessment of Cardiac Events-Prospective AMI study of 3369 consecutive patients hospitalised with AMI from 53 hospitals. Educational attainment was categorised as: high (senior high school, college or postgraduate degree), intermediate (junior high school) or low (primary school or illiterate). We used survival models to assess the relationship between education and 1-year major adverse cardiovascular events (MACE), all-cause mortality, both unadjusted and after adjustment for demographic characteristics and cardiovascular risk factors. Results The median participant age was 61 (52, 69) years, 23.2% were women, and 33.3% had high, 32.4% intermediate and 34.3% low educational attainment. In unadjusted analysis, compared with high educational attainment, low educational attainment was associated with a higher 1-year risk of MACE (HR 2.41, 95% CI 1.72 to 3.37) and death (HR for low vs high education 3.09, 95% CI 1.69 to 5.65). In risk-adjusted analyses, the association between education and death was attenuated and no longer statistically significant (adjusted HR 1.41, 95% CI 0.74 to 2.69, p=0.30). However, the risk of 1-year MACE (adjusted HR 1.68, 95% CI 1.18 to 2.41, p=0.004) remained significantly greaterin low educational attainment group. Conclusions In a national Chinese cohort of patients hospitalised with AMI, low educational attainment was associated with a higher risk of adverse events in the year following discharge. This association highlights the need to consider interventions to improve AMI outcomes in adults with low levels of education. Clinical trial registration NCT01624909; Results.
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Affiliation(s)
- Xiqian Huo
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rohan Khera
- Division of Cardiology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Lihua Zhang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Xueke Bai
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qianying Wang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale-New Heaven Hospital, New Heaven, Connecticut, USA
| | - Khurram Nasir
- Center for Outcomes Research and Evaluation, Yale-New Heaven Hospital, New Heaven, Connecticut, USA
| | - Shuang Hu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Zheng
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Frederick A Masoudi
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Connecticut, USA
| | - John A Spertus
- Health Outcomes Research, Saint Luke's Mid America Heart Institude/University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.,Center for Outcomes Research and Evaluation, Yale-New Heaven Hospital, New Heaven, Connecticut, USA.,Department of Health Policy and Management, Yale Univeristy School of Public Health, New Heaven, Connecticut, USA
| | - Lixin Jiang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Esses DFS, Costa FWG, Sá CDL, Silva PGB, Bezerra TMM, Carvalho FSR, de Medeiros JR, Soares ECS. Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study. Med Oral Patol Oral Cir Bucal 2018; 23:e13-e22. [PMID: 29274150 PMCID: PMC5822534 DOI: 10.4317/medoral.21969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. Material and Methods A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. Results A total of 338 patients rendered 355 fractures. Males were the most affected (p<0.001), with prevalence in the third decade of life (p<0.001). There was a predominance of motorcycle accidents (p<0.001), home workers (p<0.001), low educational status (p = 0.032), and no cigarette use (p<0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p<0.001). Conclusions The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period. Key words:Epidemiological studies, trauma, facial bones.
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Affiliation(s)
- D-F-S Esses
- Rua Alexandre Barauna 949 - Rodolfo Teofilo, Postal Code: 60430-160 Fortaleza, Ceara, Brazil,
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