在家庭医疗中就诊的成年人中多种疾病并存的患病率。
Prevalence of multimorbidity among adults seen in family practice.
作者信息
Fortin Martin, Bravo Gina, Hudon Catherine, Vanasse Alain, Lapointe Lise
机构信息
Department of Family Medicine, Sherbrooke University, Québec, Canada.
出版信息
Ann Fam Med. 2005 May-Jun;3(3):223-8. doi: 10.1370/afm.272.
PURPOSE
There are few valid data that describe the extent of multimorbidity in primary care patients. The purpose of this study was to estimate its prevalence in family practice patients by counting the number of chronic medical conditions and using a measure that considers the severity of these conditions, the Cumulative Illness Rating Scale (CIRS).
METHODS
The study was carried out in the Saguenay region (Québec, Canada) in 2003. The participation of adult patients from 21 family physicians was solicited during consecutive consultation periods. A research nurse reviewed medical records and extracted the data regarding chronic illnesses. For each chronic condition, a severity rating was determined in accordance with the CIRS scoring guidelines.
RESULTS
The sample consisted of 320 men and 660 women. Overall, 9 of 10 patients had more than 1 chronic condition. The prevalence of having 2 or more medical conditions in the 18- to 44-year, 45- to 64-year, and 65-year and older age-groups was, respectively, 68%, 95%, and 99% among women and 72%, 89%, and 97% among men. The mean number of conditions and mean CIRS score also increased significantly with age.
CONCLUSIONS
Whether measured by simply counting the number of conditions or using the CIRS, the prevalence of multimorbidity is quite high and increases significantly with age in both men and women. Patients with multimorbidity seen in family practice represent the rule rather than the exception.
目的
描述初级保健患者中多种疾病并存情况的有效数据较少。本研究的目的是通过统计慢性疾病的数量，并使用一种考虑这些疾病严重程度的测量方法——累积疾病评定量表（CIRS），来估计家庭医疗患者中多种疾病并存的患病率。
方法
2003年在加拿大魁北克省萨格奈地区开展了这项研究。在连续的会诊期间，邀请了21位家庭医生的成年患者参与。一名研究护士查阅病历并提取有关慢性病的数据。对于每种慢性病，根据CIRS评分指南确定严重程度等级。
结果
样本包括320名男性和660名女性。总体而言，十分之九的患者患有不止一种慢性病。在18至44岁、45至64岁以及65岁及以上年龄组中，患有两种或更多疾病的女性患病率分别为68%、95%和99%，男性患病率分别为72%、89%和97%。疾病数量的平均值和CIRS评分平均值也随年龄显著增加。
结论
无论通过简单计算疾病数量还是使用CIRS来衡量，多种疾病并存的患病率都相当高，且在男性和女性中均随年龄显著增加。在家庭医疗中见到的患有多种疾病的患者是常态而非例外。
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