1
|
Feng J, Cao D, Zheng D, Qian ZM, Huang C, Shen H, Liu Y, Liu Q, Sun J, Jiao G, Yang X, McMillin SE, Wang C, Lin H, Zhang X, Zhang S. Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160726. [PMID: 36502973 DOI: 10.1016/j.scitotenv.2022.160726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.
Collapse
Affiliation(s)
- Jin Feng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dawei Cao
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Dashan Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 102200, China; Institute of Healthy China, Tsinghua University, Beijing 102200, China
| | - Huiqing Shen
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Yi Liu
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, Zhejiang, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing 102200, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing 102200, China
| | - Stephen Edward McMillin
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xinri Zhang
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China.
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
| |
Collapse
|
2
|
Tong X, Yin P, Liu W, Chen S, Geldsetzer P, Long Z, Cheng A, Zhou M, Li Y. Spatial, temporal and demographic patterns in asthma mortality in China: A systematic analysis from 2014 to 2020. World Allergy Organ J 2023; 16:100735. [PMID: 36789097 PMCID: PMC9900450 DOI: 10.1016/j.waojou.2022.100735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/04/2022] [Accepted: 12/08/2022] [Indexed: 01/29/2023] Open
Abstract
Background Asthma is an important contributor to the burden of non-communicable diseases in China. Understanding spatial, temporal, and demographic patterns in asthma mortality is relevant to the design and implementation of targeted interventions. Methods This study collected information on asthma deaths occurring across 605 disease surveillance points (DSPs) as recorded in the population-based national mortality surveillance system (NMSS) of China. Asthma was defined according to the International Classification of Diseases, 10th Revision code J45-J46. Estimates of age-standardized mortality rates and total national asthma deaths were calculated based on yearly population data. Statistical analysis was performed to investigate the influence of various factors on asthma mortality. Results Between 2014 and 2020, a total of 40 116 asthma deaths occurred in DSPs. Standardized asthma mortality per 100 000 people decreased from 1.79 (95% CI: 1.74-1.83) in 2014 to 1.07 (95% CI: 1.03-1.10) in 2020 in China. In 2020, the overall asthma mortality rate was higher for male patients than for female patients, and asthma mortality rates increased substantially with age. Age-standardized asthma mortality per 100,000 people exhibited significant geographic variation, ranging from 0.93 (95% CI: 0.89-0.98) in Eastern China to 1.04 (95% CI: 0.98-1.10) in Central China and 1.37 (95% CI: 1.29-1.45) in Western China in 2020. Asthma mortality in urban areas appeared to be higher than in rural areas. Socioeconomic factors, including gross domestic product per capita and density of hospital beds per 10,000 population, may be related to asthma mortality. Male asthma patients who lived in rural areas and were aged 65 years and above were generally at high risk of asthma-related mortality. Conclusions This study found a spatial and temporal trend for a reduction in asthma deaths over seven years in China; however, there remain important sociodemographic groups that have not secured the same decrease in mortality rates. Trial registration This was a purely observational study and thus registration was not required.
Collapse
Affiliation(s)
- Xunliang Tong
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Peng Yin
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Wei Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Simiao Chen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Pascal Geldsetzer
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Zheng Long
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Anqi Cheng
- Department of Tobacco Control and Prevention of Respiratory Diseases China-Japan Friendship Hospital, Beijing, China,WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China,National Center for Respiratory Medicine, Beijing, China,National Clinical Research Center for Respiratory Diseases, Beijing, China,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China,Corresponding author. National Center for Chronic and Non-Communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Yanming Li
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China,Corresponding author. Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China
| |
Collapse
|
3
|
Yuan X, Kou C, Zhang M, Ma W, Tang Z, Sun H, Li W. Injury and Poisoning Mortality Trends in Urban and Rural China from 2006 to 2020 Based on Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7172. [PMID: 35742421 PMCID: PMC9223563 DOI: 10.3390/ijerph19127172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 02/04/2023]
Abstract
Injury and poisoning, common public health problems, currently rank fifth among the causes of death in China. In this study, we aimed to analyze the trends and influencing factors of injury and poisoning mortality in urban and rural China using an age-period-cohort model. Crude mortality data for injury and poisoning by sex, age group, and region were obtained from the China Health Statistical Yearbook (2006-2020). Age-standardized mortality rates for injury and poisoning in urban and rural areas were estimated using the Seventh Census of China 2020 population. The trends of injury and poisoning mortality were assessed using Joinpoint analysis. Age-period-cohort models were used to explore the age, period, and birth cohort effects affecting mortality risk. Over a 15-year period, age-standardized mortality rates decreased from 28.81/100,000 in 2006 to 24.78/100,000 in 2020 in urban areas and from 45.49/100,000 to 44.39/100,000 in rural areas. In the male population, the annual change in mortality was -0.4% (95% CI = -1.8%, 1.0%) in urban areas and -1.0% (95% CI = -1.9%, 0.0%) in rural areas. In the female population, the annual change in mortality was -1.2% (95% CI = -2.3%, -0.1%) in urban areas compared with -1.6% (95% CI = -3.1%, -0.1%) in rural areas. The age-period-cohort model showed a significant increase in urban and rural mortality rates starting at ages 49 and 39 years. Both showed a decline followed by an increase in the period. The cohort from 1929 to 2013 showed an overall trend of increasing and then decreasing. From 2006 to 2020, the overall injury and poisoning mortality rates in China showed a decreasing trend, and the mortality rates decreased faster in women than in men and in rural areas than in urban areas. Age effects were the most important risk factors for changes in injury and poisoning mortality. The results of this study will help researchers explore the possible causes of mortality changes in urban and rural areas and provide a scientific basis for injury and poisoning prevention and control priorities and policy formulation in China.
Collapse
Affiliation(s)
- Xin Yuan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (X.Y.); (M.Z.); (W.M.); (Z.T.); (H.S.)
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China;
| | - Min Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (X.Y.); (M.Z.); (W.M.); (Z.T.); (H.S.)
| | - Wenyuan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (X.Y.); (M.Z.); (W.M.); (Z.T.); (H.S.)
| | - Zhitao Tang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (X.Y.); (M.Z.); (W.M.); (Z.T.); (H.S.)
| | - Haiyan Sun
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (X.Y.); (M.Z.); (W.M.); (Z.T.); (H.S.)
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (X.Y.); (M.Z.); (W.M.); (Z.T.); (H.S.)
| |
Collapse
|
4
|
Park EH, Kim H, Heo J. The impact of size-segregated particle properties on daily mortality in Seoul, Korea. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:45248-45260. [PMID: 35141828 DOI: 10.1007/s11356-022-19069-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
To investigate the causative component for certain health outcomes, the associations between the properties of ambient particles and cause-specific mortality (all-cause, cardiovascular, and respiratory-related mortality) measured in Seoul, Korea, from January 1, 2013, to December 31, 2016, were evaluated with a quasi-Poisson generalized additive model (GAM). The total mass of PM10 and PM2.5 moderately affected respiratory-related mortality but had almost no impact on all-cause and cardiovascular-related mortality. Among PM2.5 mass compositions, ammonium sulfate, which is in generally 300-500 nm as a secondary species, showed the most statistically significant effect on respiratory-related mortality at lag 4 (p < 0.1) but not for other mortalities. However, from the size-selective investigations, cardiovascular-related mortality was impacted by particle number concentrations (PNCs), particle surface concentrations (PSCs), and particle volume concentrations (PVCs) in the size range from 50 to 200 nm with a statistically significant association, particularly at lag 1, suggesting that mass is not the only way to examine mortality, which is likely because mass and chemical composition concentrations are generally controlled by larger-sized particles. Our study suggests that the size-specific mortality and/or impacts of size-resolved properties on mortalities need to be evaluated since smaller particles get into the body more efficiently, and therefore, more diverse size-dependent causes and effects can occur.
Collapse
Affiliation(s)
- Eun Ha Park
- Institute of Health and Environment, Seoul National University, Seoul, 08826, Republic of Korea
| | - Hwajin Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Jongbae Heo
- Busan Development Institute, Busan, 47210, Republic of Korea
| |
Collapse
|
5
|
Qin Y, Liu R, Wang Y, Tang J, Cong L, Ren J, Tang S, Du Y. Self-Reported Sleep Characteristics Associated with Cardiovascular Disease Among Older Adults Living in Rural Eastern China: A Population-Based Study. Clin Interv Aging 2022; 17:811-824. [PMID: 35611325 PMCID: PMC9124474 DOI: 10.2147/cia.s361876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the cross-sectional associations of self-reported sleep characteristics with cardiovascular diseases (CVDs) and cardiovascular multimorbidity in older adults living in rural Eastern China. Patients and Methods This population-based study included 4618 participants (age ≥65 years; 56.5% women) living in rural Eastern China. In March–September 2018, data were collected through interviews, clinical examinations, neuropsychological testing, and laboratory tests. Sleep parameters were assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Berlin questionnaire. Coronary heart disease (CHD), heart failure (HF), and stroke were defined according to in-person interviews, clinical and neurological examinations, and electrocardiogram examination. Data were analyzed using logistic regression and restricted cubic spline regression. Results CHD was diagnosed in 991 participants, HF in 135 participants, and stroke in 696 participants. The multivariable-adjusted odds ratio (OR) of CHD was 1.27 (95% CI, 1.09–1.49) for sleep duration ≤6 hours/night (vs >6–8 hours/night), 1.40 (1.20–1.62) for poor sleep quality, and 1.22 (1.04–1.43) for high risk for obstructive sleep apnea (OSA). The OR of HF was 2.16 (1.38–3.39) for sleep duration >8 hours/night, and 1.76 (1.22–2.54) for high risk for OSA. In addition, the OR of stroke was 1.23 (1.04–1.46) for poor sleep quality, 1.32 (1.01–1.72) for excessive daytime sleepiness, and 1.42 (1.19–1.70) for high risk for OSA. The associations of poor sleep with cardiovascular multimorbidity (≥2 CVDs) were stronger than that of sleep problems with a single CVD. Conclusion Extreme sleep duration, high risk for OSA, and other sleep problems were associated with CVDs, especially cardiovascular multimorbidity.
Collapse
Affiliation(s)
- Yu Qin
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Jiyou Tang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
- Correspondence: Yifeng Du; Shi Tang, Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, Shandong, 250021, People’s Republic of China, Tel +86 531 68776354; +86-18678780912, Fax +86 531 68776354, Email ;
| |
Collapse
|
6
|
Zhu Y, Guo P, Zou Z, Li X, Cao M, Ma J, Jing J. Status of Cardiovascular Health in Chinese Children and Adolescents. JACC: ASIA 2022; 2:87-100. [PMID: 36340258 PMCID: PMC9627810 DOI: 10.1016/j.jacasi.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 01/14/2023]
Abstract
Background The American Heart Association defined “ideal cardiovascular health (CVH)” in pediatric populations to promote primordial prevention in cardiovascular diseases. Little is known about CVH and associated sociodemographic factors among Chinese children and adolescents. Objectives This study aimed to evaluate CVH and the associations with sociodemographic characteristics in Chinese children and adolescents. Methods This cross-sectional study analyzed baseline data of 15,583 participants aged 7 to 17 years from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated according to 4 health behaviors (nonsmoking, body mass index, physical activity, and diet) and 3 health factors (total cholesterol, blood pressure, and fasting plasma glucose), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and the number of ideal CVH metrics. Results The prevalence of ideal CVH status was 1.7% (males: 1.9%; females: 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors was 3.1% (males 3.3%; females: 3.0%) and 53.6% (males: 52.4%; females: 54.9%), respectively. Ideal fasting plasma glucose was the most prevalent component (males: 94.4%; females: 97.4%), whereas ideal physical activity (males: 34.6%; females: 23.9%) and diet (males: 28.3%; females: 30.1%) were the least prevalent. Female sex, younger age, undeveloped economy, residence in the southern region, and no family history of cardiovascular diseases were associated with more ideal CVH metrics. Conclusions Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet are key to promotion of CVH. Effective interventions are needed to promote CVH and reduce health disparities in early life.
Collapse
|
7
|
An elevated monocyte-to-high-density lipoprotein-cholesterol ratio is associated with mortality in patients with coronary artery disease who have undergone PCI. Biosci Rep 2021; 40:225998. [PMID: 32766711 PMCID: PMC7432996 DOI: 10.1042/bsr20201108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/20/2020] [Accepted: 08/05/2020] [Indexed: 01/20/2023] Open
Abstract
Background: The aim of the present study was to investigate the association between the monocyte-to-high-density lipoprotein–cholesterol ratio (MHR) and the outcomes of patients with coronary artery disease (CAD) who were treated with percutaneous coronary intervention (PCI). Methods: A total of 5679 CAD patients from CORFCHD-PCI, a retrospective cohort study (identifier: ChiCTR-ORC-16010153), who underwent PCI were included in the study and divided into three tertiles according to their MHR values. The primary outcome was long-term mortality after PCI. The main secondary endpoints were stroke, readmission, and major adverse cardiovascular events (MACEs), defined as the combination of cardiac death, recurrent myocardial infarction, and target vessel reconstruction. The average follow-up time was 35.9 ± 22.6 months. Results: Patients were divided into three groups according to MHR tertiles: the first tertile (MHR < 0.4; n=1290), second tertile (MHR ≥ 0.4–0.61; n=1878) and third tertile (MHR > 0.61; n=1870). The all-cause mortality (ACM) incidence was significantly lower in the first and second tertiles than in the third tertile (adjusted HR = 0.658, [95% CI: 0.408–0.903], P=0.009 and HR = 0.712, [95% CI: 0.538–0.941], P=0.017, respectively). Cardiac mortality (CM) occurred in 235 patients: 60 (3.1%) in the first tertile group, 74 (3.9%) in the second tertile group and 101 (5.4%) in the third tertile group. There was a significant difference in the CM incidence between the first tertile group and the third tertile group (HR = 0.581, [95% CI: 0.406–0.832], P=0.003), and there was also a difference in the CM incidence between the second tertile group and the third tertile group (HR = 0.690, [95% CI: 0.506–0.940], P=0.019). Conclusion: The present study indicated that an increased MHR was independently associated with long-term mortality in CAD patients who have undergone PCI.
Collapse
|
8
|
Cong L, Ren Y, Hou T, Han X, Dong Y, Wang Y, Zhang Q, Liu R, Xu S, Wang L, Du Y, Qiu C. Use of Cardiovascular Drugs for Primary and Secondary Prevention of Cardiovascular Disease Among Rural-Dwelling Older Chinese Adults. Front Pharmacol 2020; 11:608136. [PMID: 33424613 PMCID: PMC7793651 DOI: 10.3389/fphar.2020.608136] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/23/2020] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular risk factors and related disorders are common among older adults, and use of various classes of cardiovascular (CV) drugs could reduce the risk of cardiovascular disease (CVD). However, data are sparse with regard to the use of CV drugs among rural-dwelling older adults in China. Therefore, this population-based study aimed to describe use of CV drugs among older adults living in the rural communities in China, while taking into account the use of CV drugs for primary and secondary prevention of CVDs. This study included 5,246 participants (age ≥65 years; 57.17% women; 40.68% illiteracy) in the baseline examination of the MIND-China study. In March-September 2018, data on health-related factors, CVDs (ischemic heart disease, atrial fibrillation, heart failure, and stroke), and CV drug use were collected via face-to-face survey, clinical examination, and laboratory tests. We classified CV drugs according to the Anatomical Therapeutic Chemical classification system for western medications and specific cardiovascular effects for the products of traditional Chinese medicine (TCM). We conducted descriptive analysis. The overall prevalence of major cardiovascular risk factors ranged from 14.30% in diabetes and 23.81% in dyslipidemia to 66.70% in hypertension, and CVDs affected 35.07% of all participants (36.28% in women vs. 33.47% in men, p = 0.035). In the total sample, calcium channel blockers (C08) were most commonly used (10.39%), followed by TCM products (7.64%), hypoglycemic agents (A10, 4.73%), renin-angiotensin system (RAS)-acting agents (C09, 4.61%), and lipid-lowering agents (C10, 4.17%). The proportions of CV drugs for primary prevention (i.e., use of CV drugs among people without CVD) were 3.14% for antithrombotic agents (mainly aspirin), 1.38% for lipid-lowering agents, and 3.11% for RAS-acting agents; the corresponding figures for secondary prevention (i.e., use of CV drugs among people with CVD) were 13.97%, 9.35%, and 7.39%. In conclusion, despite highly prevalent cardiovascular risk factors and CVDs, a fairly low proportion of the rural-dwelling older adults take CV medications for primary and secondary prevention. Notably, TCM products are among the most commonly used CV drugs. These results call for additional efforts to promote implementation of the evidence-based recommendations for prevention of CVDs in the primary care settings.
Collapse
Affiliation(s)
- Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, China
| | - Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, China
| | - Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shan Xu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lidan Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
9
|
Liu Y, Lv X, Xie N, Fang Z, Ren W, Gong Y, Jin Y, Zhang J. Time trends analysis of statin prescription prevalence, therapy initiation, dose intensity, and utilization from the hospital information system of Jinshan Hospital, Shanghai (2012-2018). BMC Cardiovasc Disord 2020; 20:201. [PMID: 32334525 PMCID: PMC7183656 DOI: 10.1186/s12872-020-01482-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Statin remains a mainstay in the prevention and treatment of cardiovascular diseases. Statin utilization has evolved over time in many countries, but data on this topic from China are quite limited. This study aimed to investigate the changing trends of statins prescription, as well as detail the statin utilization through a successive longitudinal study. METHODS The prescription database was established based on electronic health records retrieved from the hospital information system of Jinshan Hospital, Fudan University from January 2012 to December 2018 in Shanghai, China. The prescription rates and proportions of different statin types and doses among all patients were examined. Sub-analyses were performed when stratifying the patients by age, gender, dose intensity, and preventative intervention. RESULTS During the study period, a total of 51,083 patients, who were prescribed for statins, were included in this study (mean [SD] age, 59.78 [±13.16] years; 53.60% male, n = 27, 378). The overall statins prescription rate in which patients increased from 2012 (1.24, 95% CI: 1.21-1.27%) to 2018 (3.16, 95% CI: 3.11-3.20%), P < 0.001. Over 90% of patients were given a moderate dose of statins. Patients with a history of coronary and cerebrovascular events (over 32%) were more likely to be prescribed with statins for preventative intervention. Furthermore, our study has witnessed a significant rise in statin therapy in primary and secondary prevention. CONCLUSIONS In conclusion, statins were frequently prescribed and steadily increased over time in our study period. There were also changes in statin drug choices and dosages. A coordinated effort among the patient, clinical pharmacist, stakeholders and health system is still needed to improve statin utilization in clinical practice in the future.
Collapse
Affiliation(s)
- Yujuan Liu
- Department of Clinical Pharmacy, Jinshan Hospital Affiliated to Fudan University, Shanghai, 201508 China
| | - Xiaoqun Lv
- Department of Clinical Pharmacy, Jinshan Hospital Affiliated to Fudan University, Shanghai, 201508 China
| | - Ning Xie
- Department of Clinical Pharmacy, Zhongshan Hospital Qingpu Branch Affiliated to Fudan University, Shanghai, 201799 China
| | - Zhonghong Fang
- Department of Clinical Pharmacy, Jinshan Hospital Affiliated to Fudan University, Shanghai, 201508 China
| | - Weifang Ren
- Department of Clinical Pharmacy, Jinshan Hospital Affiliated to Fudan University, Shanghai, 201508 China
| | - Yuan Gong
- Department of Clinical Pharmacy, Jinshan Hospital Affiliated to Fudan University, Shanghai, 201508 China
| | - Yan Jin
- Shihua Community Health Service Center, Jinshan District, Shanghai, 200540 China
| | - Jun Zhang
- Department of Clinical Pharmacy, Jinshan Hospital Affiliated to Fudan University, Shanghai, 201508 China
| |
Collapse
|
10
|
Wang C, Hao L, Liu C, Chen R, Wang W, Chen Y, Yang Y, Meng X, Fu Q, Ying Z, Kan H. Associations between fine particulate matter constituents and daily cardiovascular mortality in Shanghai, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 191:110154. [PMID: 31954217 DOI: 10.1016/j.ecoenv.2019.110154] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 12/26/2019] [Accepted: 12/30/2019] [Indexed: 05/10/2023]
Abstract
Limited evidence is available for the associations between fine particulate matter (PM2.5) constituents and daily cardiovascular disease (CVD) mortality in China. In present study, a time-series analysis was conducted to evaluate the associations of PM2.5 constituents (two carbonaceous fractions, eight water-soluble inorganic ions and fifteen elements) with daily CVD mortality in Pudong New Area of Shanghai, China, from 2014 to 2016. Results showed that the effect estimates for the associations of PM2.5 and its constituents with CVD mortality were generally strongest when using the exposures of the previous two day concentrations. The associations of organic carbon, sulfate, ammonia, potassium, copper, arsenic, and lead with daily CVD mortality were robust to the adjustment of PM2.5 total mass, their collinearity with PM2.5 total mass, and criteria gaseous air pollutants. An interquartile range increase in the previous two day concentrations of PM2.5, organic carbon, sulfate, ammonia, potassium, copper, arsenic, and lead were associated with significant increments of 2.21% (95% confidence interval [95%CI]: 0.54%, 3.88%), 2.83% (95% CIs: 1.16%, 4.50%), 1.90% (95% CIs: 0.35%, 3.45%), 2.29% (95% CIs: 0.80%, 3.77%), 0.94% (95% CIs: 0.13%, 1.75%), 1.53% (95% CIs: 0.37%, 2.69%), 2.08% (95% CIs: 0.49%, 3.68%) and 1.98% (95% CIs: 0.49%, 3.47%) in daily CVD mortality, respectively, in single-pollutant models. In conclusion, this study suggested that organic carbon, sulfate, ammonia, potassium, copper, arsenic, and lead might be mainly responsible for the associations between short-term PM2.5 exposures and increased CVD mortality in Shanghai, China.
Collapse
Affiliation(s)
- Cuiping Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Lipeng Hao
- Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yichen Chen
- Shanghai Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Yining Yang
- Beijing No.171 High School, Beijing, 100013, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China.
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, 200235, China.
| | - Zhekang Ying
- Department of Medicine Cardiology Division, University of Maryland School of Medicine, 20 Penn St. HSFII S005, Baltimore, MD, 21201, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| |
Collapse
|
11
|
Cen X, Wang D, Sun W, Cao L, Zhang Z, Wang B, Chen W. The trends of mortality and years of life lost of cancers in urban and rural areas in China, 1990-2017. Cancer Med 2019; 9:1562-1571. [PMID: 31873982 PMCID: PMC7013076 DOI: 10.1002/cam4.2765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 12/18/2022] Open
Abstract
Background With the rapid development of the socioeconomic status, the mortality of several cancers has been changed in China during the past 30 years. We aimed to estimate the trends of mortality and years of life lost (YLLs) of various cancers in urban and rural areas of China from 1990 to 2017. Methods The mortality data were collected from Chinese yearbooks and the age structure of population from the Chinese sixth population census were used as reference to calculate age‐standardized mortality rates (ASMRs) and YLLs rates. Joinpoint regression analysis was implemented to calculate the annual percent change (APC) of mortality rates and YLL rates for cancers. YLLs owing to premature death were calculated as age‐specific cancer deaths multiplied by the reference life expectancy at birth of 80 years for male and 82.5 years for female. Results The ASMRs of all cancers showed significant decreasing trends for urban residents from 1990 to 2017, such downward trend without significance was also observed among rural residents. Interestingly, ASMRs of lung cancer and breast cancer have raised continuously in rural areas since 1990. The age‐standardized YYL rates for urban and rural residents decreased with 1.02% and 0.85% per year, respectively. YLLs in rural areas were higher than those in urban areas, whereas YLLs of urban outstripped those of rural finally with the increasing in YLLs of urban areas (216.71% for men and 207.87% for women). Conclusion The ASMRs and YLL rates of all cancers have declined in urban and rural areas from 1990 to 2017. YLLs increased in urban areas and remained higher level in rural areas after 2014 year. Preventive measures should be strengthened to against cancer, especially for lung cancer.
Collapse
Affiliation(s)
- Xingzu Cen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiwei Sun
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Examining Division for Materials Engineering Inventions, China National Intellectual Property Administration, Beijing, China
| | - Limin Cao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuang Zhang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
12
|
Zhu Y, Liu C, Zhang Y, Shi Q, Kong Y, Wang M, Xia X, Zhang F. Identification and resolution of drug-related problems in a tertiary hospital respiratory unit in China. Int J Clin Pharm 2019; 41:1570-1577. [PMID: 31654364 DOI: 10.1007/s11096-019-00922-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 10/09/2019] [Indexed: 12/23/2022]
Abstract
Background The prevalence of drug-related problems in patients hospitalized at respiratory care units is unknown in mainland China. Objective To identify and categorize drug-related problems in a respiratory care unit in China. Setting Respiratory care unit in a tertiary university hospital in China. Methods Clinical pharmacy services were introduced and documented during an 18-months study period. The problems were categorized using the Pharmaceutical Care Network Europe DRP classification tool V8.02. Main outcome measures Problems and causes of drug-related problems, interventions proposed, and outcome of pharmacy recommendations. Results A total of 474 patients were reviewed, 164 patients had DRPs (34.6%). Total 410 problems were identified, an average of 2.5 per patient. Treatment effectiveness was the major type of problem detected (219; 53.4%) followed by treatment safety (140; 34.1%). The most common causes of the problems were patient-related (25.8%), drug selection (24.0%), and drug use process (23.4%). Pharmacist made 773 interventions; average 1.9 per drug-related problem. A total of 96.2% of these interventions were accepted leading to solving 81.9% of the identified problems. Conclusion There is a high prevalence of drug-related problems in patients hospitalized at the respiratory unit of this clinic. Clinical pharmacists should focus on improving prescribing practice and patient counseling.
Collapse
Affiliation(s)
- Yulin Zhu
- Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Cheng Liu
- Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Yong Zhang
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.
| | - Qingping Shi
- Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Yiqiu Kong
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Muqun Wang
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Xuemei Xia
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Feng Zhang
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| |
Collapse
|
13
|
Zhao Y, Huang Z, Wang S, Hu J, Xiao J, Li X, Liu T, Zeng W, Guo L, Du Q, Ma W. Morbidity burden of respiratory diseases attributable to ambient temperature: a case study in a subtropical city in China. Environ Health 2019; 18:89. [PMID: 31651344 PMCID: PMC6814053 DOI: 10.1186/s12940-019-0529-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/01/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND There are significant associations between ambient temperature and respiratory disease mortality. However, few studies have assessed the morbidity burdens of various respiratory diseases that are attributable to different temperature ranges in subtropical regions. METHODS Daily outpatient visits, weather variables, and air pollution data were collected from January 2013 to August 2017 in a hospital in Dongguan city. A standard time series quasi-Poisson regression with a distributed lag non-linear model (DLNM) was applied to estimate the associations between daily mean temperature and morbidity for total respiratory diseases, bronchiectasis, chronic obstructive pulmonary disease (COPD), and asthma. Attributable fractions were then calculated to quantify disease burden relative to different temperature components. Finally, we conducted stratified analysis by age group. RESULTS Both low and high temperatures were associated with an increased risk of morbidity secondary to respiratory diseases. Compared with the optimum temperature, the accumulated relative risk (RR) during the seven lag days was 1.13 with a 95% confidence interval (CI) of 1.01-1.26 for extreme heat and 1.02 (95% CI: 0.99-1.05) for extreme cold. Heat-related respiratory morbidity risk was higher than cold-related risk for the total population, but an opposite result was observed for the elderly. About 8.4% (95% CI: 2.8-13.3%) of respiratory morbidity was attributable to non-optimal temperatures, and moderate heat was responsible for most of the excess respiratory morbidity (7.5, 95% CI: 2.4-12.2%). CONCLUSIONS We found that exposure to non-optimal temperatures increased the risk of respiratory morbidity in subtropical region, and moderate heat contributed to most of the temperature-related respiratory morbidities. This indicates a need for further examination of moderate, rather than extreme, heat in subtropical region.
Collapse
Affiliation(s)
- Yiju Zhao
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan, China
| | - Zhao Huang
- The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | | | - Jianxiong Hu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Qingfeng Du
- Nanhai Hospital of Southern Medical University, Foshan, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
- Nanhai Hospital of Southern Medical University, Foshan, China.
| |
Collapse
|
14
|
Liu L. China's dusty lung crisis: Rural-urban health inequity as social and spatial injustice. Soc Sci Med 2019; 233:218-228. [PMID: 31229908 DOI: 10.1016/j.socscimed.2019.05.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 04/20/2019] [Accepted: 05/20/2019] [Indexed: 01/05/2023]
Abstract
This paper examines rural-urban inequities in dusty lung (pneumoconiosis) deaths in China from 2002 to 2016 and possible causes for such inequities in the framework of social and spatial justice. The research reveals alarming results that have not been reported before. Dusty lung death rates for rural men increased twice as fast as those among urban men. The rural rates were particularly higher among middle-aged men, but lower in older age groups, as compared to urban rates. There were dramatic increases in death rates from 2011 to 2016 particularly among rural men aged 40-49 years old, who were many times more likely to die from dusty lung than urban men of a similar age. Chinese rural male victims also die at a younger age, compared to men in any of the seven countries or regions included in the study. For example, rural Chinese men aged 35-59 years old were many times more likely to die from dusty lung than their American, German, Polish, and Spanish counterparts. A possible explanation for the high death rates among middle-aged rural Chinese men is the tendency for rural migrant workers to be employed in unhealthy and unsafe working conditions in decent decades. Other explanations for the severe spatial injustice include the Hukou (household registration) system and the development policies that prioritize economic growth and urban development over occupational health and safety. The paper demonstrates the usefulness and weakness of the social and spatial justice concepts in understanding health inequity. Therefore, it proposes new definitions and models of social justice and spatial justice that combine the competing distribution and capabilities approaches and highlight interactions among multiple attributes.
Collapse
Affiliation(s)
- Lee Liu
- School of Geoscience, Physics, and Safety, College of Health, Science, and Technology, University of Central Missouri, Humphreys 225, Warrensburg, MO, 64093, USA.
| |
Collapse
|
15
|
Cai M, Liu E, Li W. Rural Versus Urban Patients: Benchmarking the Outcomes of Patients with Acute Myocardial Infarction in Shanxi, China from 2013 to 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091930. [PMID: 30189602 PMCID: PMC6165441 DOI: 10.3390/ijerph15091930] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 12/12/2022]
Abstract
Rural-urban disparity in China attracts special international attention in view of the imbalance of economic development between rural and urban areas. However, few studies used patient level data to explore the disparity of health outcomes between rural and urban patients. This study aims to evaluate the trend of health outcomes between rural and urban patients hospitalized with acute myocardial infarction (AMI) in China. Using an electronic medical records (EMRs) database in Shanxi, China, we identified 87,219 AMI patients hospitalized between 2013 and 2017. We used multivariable binary logistic regressions and two-part models to estimate the association between region of origin (rural/urban) and two outcomes, in-hospital mortality and out-of-pocket (OOP) expenses. Rural patients were associated with lower in-hospital mortality and the adjusted Odds Ratios (ORs) were 0.173, 0.34, 0.605, 0.522, 0.556 (p-values < 0.001) from 2013 to 2017, respectively. For the OOP expenses, rural patients were experiencing increasing risk of having OOP expenses, with the ORs of 0.159, 0.573, 1.278, 1.281, 1.65. The coefficients for the log-linear models in the five years were 0.075 (p = 0.352), 0.61, 0.565, 0.439, 0.46 (p-values < 0.001). Policy makers in China should notice and narrow the gap of health outcomes between rural and urban patients.
Collapse
Affiliation(s)
- Miao Cai
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63103, USA.
| | - Echu Liu
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63103, USA.
| | - Wei Li
- Dongfang College, Zhejiang University of Finance and Economics, Hangzhou 314408, China.
| |
Collapse
|