本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-1990

摘要内容如下：

背景

美国不同西班牙裔/拉丁裔人群的全因死亡率和死亡率差异的潜在因素尚未进行前瞻性研究。

客观

描述COVID-19大流行之前和期间西班牙裔/拉丁裔背景的累积全因死亡率（和潜在差异因素）。

设计

前瞻性多中心队列研究。

设置

西班牙裔社区健康研究/拉丁美洲人研究。

参与者

来自纽约布朗克斯的15568名18至74岁的中美洲、古巴、多米尼加、墨西哥、波多黎各、南美洲和其他背景的成年人（2008年至2011年）；伊利诺伊州芝加哥市；佛罗里达州迈阿密；还有加州的圣地亚哥。

测量

在基线时评估社会人口统计学、文化适应相关、生活方式和临床因素，并在2021年12月确定生命状态（969例死亡；173444人年随访）。使用逐步调整的Cox回归检验了边际调整的累积全因死亡风险（大流行前11年和大流行期间2年）。

结果

大流行前，经年龄和性别调整后的11年累积死亡风险在波多黎各和古巴组较高（分别为6.3%[95%可信区间，5.2%至7.6%]和5.7%[可信区间，5.0%至6.6%]），在南美组最低（2.4%[可信区间，1.7%至3.5%]）。调整生活方式和临床因素后，差异减弱。在大流行期间，经年龄和性别调整后的2年累积死亡风险为1.1%（CI，0.6%-2.0%；南美）降至2.0%（置信区间，1.4%至3.0%；中美洲）；CI在组之间重叠。调整生活方式因素后，2年累积死亡风险在中美洲和墨西哥背景的人群中最高，在波多黎各和古巴背景的人群中最低。

局限性

缺乏关于种族和基线公民身份状况的数据；西班牙裔/拉丁裔背景与地点之间的相关性。

结论

生活方式和临床因素解释了西班牙裔/拉丁裔人群大流行前死亡风险的差异。在大流行期间，死亡率模式发生了变化，中美洲和墨西哥背景的人比波多黎各和古巴背景的人面临更高的风险。

主要资金来源

美国国立卫生研究院。

英文原文如下：

Abstracts

BACKGROUND  All-cause mortality among diverse Hispanic/Latino groups in the United States and factors underlying mortality differences have not been examined prospectively.

OBJECTIVE  To describe cumulative all-cause mortality (and factors underlying differences) by Hispanic/Latino background, before and during the COVID-19 pandemic.

DESIGN  Prospective, multicenter cohort study.

SETTING  Hispanic Community Health Study/Study of Latinos.

PARTICIPANTS  15 568 adults aged 18 to 74 years at baseline (2008 to 2011) of Central American, Cuban, Dominican, Mexican, Puerto Rican, South American, and other backgrounds from the Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California.

MEASUREMENTS  Sociodemographic, acculturation-related, lifestyle, and clinical factors were assessed at baseline, and vital status was ascertained through December 2021 (969 deaths; 173 444 person-years of follow-up). Marginally adjusted cumulative all-cause mortality risks (11-year before the pandemic and 2-year during the pandemic) were examined using progressively adjusted Cox regression.

RESULTS  Before the pandemic, 11-year cumulative mortality risks adjusted for age and sex were higher in the Puerto Rican and Cuban groups (6.3% [95% CI, 5.2% to 7.6%] and 5.7% [CI, 5.0% to 6.6%], respectively) and lowest in the South American group (2.4% [CI, 1.7% to 3.5%]). Differences were attenuated with adjustment for lifestyle and clinical factors. During the pandemic, 2-year cumulative mortality risks adjusted for age and sex ranged from 1.1% (CI, 0.6% to 2.0%; South American) to 2.0% (CI, 1.4% to 3.0%; Central American); CIs overlapped across groups. With adjustment for lifestyle factors, 2-year cumulative mortality risks were highest in persons of Central American and Mexican backgrounds and lowest among those of Puerto Rican and Cuban backgrounds.

LIMITATION  Lack of data on race and baseline citizenship status; correlation between Hispanic/Latino background and site.

CONCLUSION  Differences in prepandemic mortality risks across Hispanic/Latino groups were explained by lifestyle and clinical factors. Mortality patterns changed during the pandemic, with higher risks in persons of Central American and Mexican backgrounds than in those of Puerto Rican and Cuban backgrounds.

PRIMARY FUNDING SOURCE  National Institutes of Health.

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