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血液透析患者的复杂共病:巴西大都市地区的研究。

Complex multimorbidity in hemodialysis patients: Study in a metropolitan region in Brazil.

机构信息

Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, ES, Brazil.

出版信息

PLoS One. 2024 May 16;19(5):e0303068. doi: 10.1371/journal.pone.0303068. eCollection 2024.

Abstract

The objective of this article was to analyze the factors associated with complex multimorbidity (CMM) among hemodialysis patients in a metropolitan region in southeastern Brazil. To this end, a cross-sectional epidemiological survey was carried out with 1,024 individuals in the year 2019. CMM data were collected through the application of a questionnaire to hemodialysis patients. The binary logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) between independent variables and CMM. The prevalence of CMM was 81% and the results indicated that: living in cities with a low rate of general mortality (OR = 0.395, 95%CI = 0.179-0.870), being aged between 18 and 29 (OR = 0.402, 95%CI = 0.196-0.825), having an elementary education (OR = 0.536, 95%CI = 0.290-0.966) and assessing health as good/very good (OR = 0.446, 95%CI = 0.301-0.661) are factors that reduced the chances of having CMM, whereas a longer period of hemodialysis (OR = 1.779 and 95%CI = 1.057-2.997) increased the chances of CMM. The findings show that characteristics of the social and individual context are associated with CMM in hemodialysis patients, signaling the need for public health policies that include monitoring the complex multimorbidity condition among individuals undergoing hemodialysis treatment.

摘要

本文旨在分析巴西东南部大都市地区血液透析患者复杂多重疾病(CMM)的相关因素。为此,于 2019 年开展了一项横断面流行病学调查,共纳入 1024 名患者。通过向血液透析患者发放问卷收集 CMM 数据。采用二项逻辑回归模型估计独立变量与 CMM 之间的比值比(OR)和 95%置信区间(95%CI)。CMM 的患病率为 81%,结果表明:居住在一般死亡率较低的城市(OR=0.395,95%CI=0.179-0.870)、年龄在 18-29 岁之间(OR=0.402,95%CI=0.196-0.825)、接受过小学教育(OR=0.536,95%CI=0.290-0.966)和自感健康状况良好/非常好(OR=0.446,95%CI=0.301-0.661)的患者发生 CMM 的几率降低,而血液透析时间较长(OR=1.779,95%CI=1.057-2.997)的患者发生 CMM 的几率增加。研究结果表明,社会和个体背景特征与血液透析患者的 CMM 相关,提示需要制定公共卫生政策,以监测正在接受血液透析治疗的患者的复杂多重疾病状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b61/11098310/90d0598e3b3c/pone.0303068.g001.jpg

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