Оценка смертности по причине основных сердечно-сосудистых заболеваний в Республике Молдова

Universitatea de Stat de Medicină şi Farmacie Nicolae Testemiţanu, Institutul Cardiologic din Republica MoldovaIt is well known that cardiovascular diseases are the most important cause of mortality and disability in the world. Similar to economically developed countries, cardiovascular diseases in Republic of Moldova gained a strong importance, because of the increase of its spreading level and negative influence upon the work capacity of the population. In the 21st century cardiovascular diseases continue to be one of most health issues in Republic of Moldova. The designed research respected the requirements for descriptive study. By research volume study is integral. The manner of data collection involved the use of vital statistical data registered by National Center of Health Management and by National Bureau of Statistics from Republic of Moldova. Mortality level of major contribution cardiovascular diseases showed a negative trend for the 2008-2014 period (from 635,4 to 619,3 per 100,000 population). Specific rate mortality by cases proved to have the same tendency of decrease for the estimated period: for ischemic disease – from 425,3 to 411,0 (illustrative indicator – 96,6%) and for cerebrovascular diseases – from 189,9 to 168,5 (illustrative indicator – 88,7%), being at the same time in increase of mortality by hypertensive disease – from 20,2 to 40,2 per 100,00 population (illustrative indicator – 199,2%). General tendency of light decrease for mortality level by major contribution cardiovascular diseases in 2008-2014 period, demonstrates a relatively fragile and unstable character, having a slight increase tendency for young age groups. Therefore, it is required to ensure an observation and systematic evaluation of potential statistical indicators (Years of Potential of Life Lost – YPLL), contributing to priorities establishment for community and individual level of interventions in Republic of Moldova.Сердечно-сосудистые заболевания являются наиболее важной причиной смертности и инвалидности в мире. Подобно экономически развитым странам, сердечно-сосудистые заболевания в Республике Молдова характеризуются высоким уровнем распространения и негативного влияния на трудоспособность населения. Таким образом, в 21-м веке сердечно-сосудистые заболевания по-прежнему являются одной из главных проблем общественного здоровья в Республике Молдова. Проведенное исследование является интегральным описательным исследованием. Способ сбора данных включает использование статистических данных зарегистрированных в Национальном центре менеджмента общественного здоровья и в Национальном бюро статистики Республики Молдова. Уровень смертности от приоритетных сердечно-сосудистых заболеваний показал отрицательную динамику в период 2008-2014 гг. (от 635,4 до 619,3 на 100000 населения). Частота смертности от приоритетных сердечнососудистых заболеваний в зависимости от клинических форм продемонстрировала ту же тенденцию снижения: для ишемической болезни – от 425,3 до 411,0 на 100000 населения (иллюстративный.показатель – 96,6%) и цереброваскулярных заболеваний – от 189,9 до 168 5 на 100000 населения (иллюстративный показатель – 88,7%), вместе с тем, сопровождаясь повышением частоты смертности по причине гипертонической болезни – от 20,2 до 40,2 на 100,000 населения (иллюстративный показатель – 199,2%). В заключении, отмечается общая тенденция легкого понижения уровня смертности по причине приоритетных сердечно-сосудистых заболеваний в период 2008-2014 г., которая демонстрирует относительно хрупкий и неустойчивый характер, имея тенденцию увеличения для молодых возрастных групп. Таким образом, требуется обеспечить систематическую оценку потенциальных статистических показателей (YPLL, DALY и др.), способствуя, тем самым, оценке состояния здоровья для выявления в этой связи приоритетов для интервенций на индивидуальном и территориальном уровнях

Факторы риска сердечно-сосудистых заболеваний и нездоровое поведение в Республике Молдова в контексте европейских статистических данных.

Cardiovascular risk factors and unhealthy behaviours în the Republic of Moldova in the context of european statistical data.A fost efectuată analiza impactului factorilor de risc asupra dezvoltării și evoluției BCV în Republica Moldova comparativ cu țările membre ale Societății Europe de Cardiologie care se împart conform statutului de venituri, Moldova fiind clasată ca țară cu venituri mai mici de medii. Analiza a fost efectuată conform Atlas of Cardiology în baza datelor WHO Global Health Observator. Mortalitatea prin afecțiuni cardiovasculare în Republica Moldova este înaltă constant, aproximativ 57-58% în ultimii ani, unul dintre cei mai temuți factori de risc a bolilor cardiovasculare fiind hipertensiunea arteriala crescută, cu o prevalență standardizată de vârstă foarte înaltă >30. Au fost stabilite progrese pozitive în evoluția unor factori de risc. Astfel, Republica Moldova ocupă o poziție avantajoasă față de alte țări membre a SEC după valorile medii mici ale prevalenței hipercolesterolemiei la bărbați şi la femei. Prevalența diabetului zaharat în R Moldova este mică <3%, astfel morbiditatea prin diabet zaharat plasează R. Moldova la nivel satisfăcător printre statele europene, cu cea mai mică rată al acestui factor major de risc pentru bolile cardiovasculare.Факторы риска сердечно-сосудистых заболеваний и нездоровое поведение в Республике Молдова в контексте европейских статистических данных

Development and validation of a prediction model for severe respiratory failure in hospitalized patients with SARS-CoV-2 infection: a multicentre cohort study (PREDI-CO study)

Objectives: We aimed to develop and validate a risk score to predict severe respiratory failure (SRF) among patients hospitalized with coronavirus disease-2019 (COVID-19).Methods: We performed a multicentre cohort study among hospitalized (>24 hours) patients diagnosed with COVID-19 from 22 February to 3 April 2020, at 11 Italian hospitals. Patients were divided into derivation and validation cohorts according to random sorting of hospitals. SRF was assessed from admission to hospital discharge and was defined as: SpO(2) <93% with 100% FiO(2), respiratory rate >30 breaths/min or respiratory distress. Multivariable logistic regression models were built to identify predictors of SRF, beta-coefficients were used to develop a risk score. Trial Registration NCT04316949.Results: We analysed 1113 patients (644 derivation, 469 validation cohort). Mean (+/- SD) age was 65.7 (+/- 15) years, 704 (63.3%) were male. SRF occurred in 189/644 (29%) and 187/469 (40%) patients in the derivation and validation cohorts, respectively. At multivariate analysis, risk factors for SRF in the derivation cohort assessed at hospitalization were age >= 70 years (OR 2.74; 95% CI 1.66-4.50), obesity (OR 4.62; 95% CI 2.78-7.70), body temperature >= 38 degrees C (OR 1.73; 95% CI 1.30-2.29), respiratory rate >= 22 breaths/min (OR 3.75; 95% CI 2.01-7.01), lymphocytes <= 900 cells/mm(3) (OR 2.69; 95% CI 1.60-4.51), creatinine >= 1 mg/dL (OR 2.38; 95% CI 1.59-3.56), C-reactive protein >= 10 mg/dL (OR 5.91; 95% CI 4.88 -7.17) and lactate dehydrogenase >= 350 IU/L (OR 2.39; 95% CI 1.11-5.11). Assigning points to each variable, an individual risk score (PREDI-CO score) was obtained. Area under the receiver-operator curve was 0.89 (0.86-0.92). At a score of >3, sensitivity, specificity, and positive and negative predictive values were 71.6% (65%-79%), 89.1% (86%-92%), 74% (67%-80%) and 89% (85%-91%), respectively. PREDI-CO score showed similar prognostic ability in the validation cohort: area under the receiver-operator curve 0.85 (0.81e0.88). At a score of >3, sensitivity, specificity, and positive and negative predictive values were 80% (73%-85%), 76% (70%-81%), 69% (60%-74%) and 85% (80%-89%), respectively.Conclusion: PREDI-CO score can be useful to allocate resources and prioritize treatments during the COVID-19 pandemic. (c) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved