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    Tendência secular da mortalidade e fatores associados ao óbito precoce por doença falciforme no estado de São Paulo
    (Universidade Federal de São Paulo (UNIFESP), 2021) Souza, Nayara Dorta De [UNIFESP]; Konstantyner, Tulio [UNIFESP]; Universidade Federal de São Paulo
    Objective: To estimate the trend in the mortality rate and the average age of death, and to identify the sociodemographic factors associated with early death in patients with sickle cell disease in the State of São Paulo. Methods: Descriptive and analytical ecological and transversal study, based on data from the Mortality Information System. All events of death of patients residing in the State of São Paulo from 01/01/1996 to 12/31/2015 were included, which contained at least one International Disease Code for Sickle Cell Disease in any field of the medical certificate. death. The trends in mortality rates (general and stratified by age group) and average age of death over the years were estimated using simple linear regression. For the investigation of factors associated with early death, which was defined when death ocurred before the median life expectancy of patients with DF, univariate and multivariate survival analyzes were performed, using Cox regression. The Kaplan Meier graph was used to represent univariate associations. Results: The overall mortality rate per million inhabitants increased by 0.084 per year (R² = 0.783 and p <0.001). When stratified by age group, in the age subgroup it was greater than 20 years, the increase was 0.108 per year (R² = 0.789 and p <0.001) and in those under 20 years it was 0.023 per year (R² = 0.188 and p = 0.056). The analysis of the trend of the average age at death showed an increase of 0.617 years per year analyzed (R² = 0.835 and p <0.001 In the multivariate analysis of the factors associated with early death, being male (HR = 1.30), white (HR = 1.16), dying inside the hospital (HR = 1.29) and living in Greater São Paulo (HR = 1.13) presented a higher risk of early death, when compared to the reference categories. Conclusion: During the 20 years analyzed, there was an increase in the mortality rate and the average age of death with Sickle Cell Disease. The sociodemographic factors: sex, race, place of occurrence and municipality of residence were associated with the age range of death.