发信人: wugang (抗SARS 隔离 养膘中), 信区: SARS
标 题: 世界卫生组织7日报告·译:死亡率问题
发信站: 哈工大紫丁香 (2003年05月08日11:13:41 星期四), 站内信件
Case fatality ratio
病例死亡率
WHO has today revised its initial estimates of the case fatality ratio
of SARS. The revision is based on an analysis of the latest data from
Canada, China, Hong Kong SAR, Singapore, and Viet Nam.
今天,世界卫生组织修订了非典型肺炎的预计死亡率。基于加拿大、中国、香港、
新加坡和越南的最新数据,世界卫生组织进行了这次修订。
On the basis of more detailed and complete data, and more reliable
methods, WHO now estimates that the case fatality ratio of SARS ranges
from 0% to 50% depending on the age group affected, with an overall
estimate of case fatality of 14% to 15%.
目前的数据更加具体,更加完整,更加合理,因为世界卫生组织重新估算了非典型
肺炎的死亡率。世界卫生组织原来的预期死亡率根据不同的年龄段由0到50%不等
,目前修订成非典型肺炎总体死亡率14%-15%。
The likelihood of dying from SARS in a given area has been shown to
depend on the profile of the cases, including the age group most
affected and the presence of underlying disease. Based on data
received by WHO to date, the case fatality ratio is estimated to be less
than 1% in persons aged 24 years or younger, 6% in persons aged 25 to
44 years, 15% in persons aged 45 to 64 years, and greater than 50% in
persons aged 65 years and older.
根据易感人群的年龄段、个人情况、是否有基础疾病等因素,不同的患者的死亡率
是不同的。根据世界卫生组织最新数据分析,24岁及其以下的人群死亡率不到1%
,25-44岁人群死亡率6%,45-64岁人群死亡率15%,65岁及其以上的死亡率高
于50%。
A case fatality ratio measures the proportion of all people with a
disease who will die from the disease. In other words, it measures the
likelihood that a disease will kill its host, and is thus an important
indicator of the severity of a disease and its significance as a
public health problem. The likelihood that a person will die of SARS
could be influenced by factors related to the SARS virus, the route of
exposure and dose (amount) of virus, personal factors such as age or the
presence of another disease, and access to prompt medical care.
所谓"疾病死亡率"是指所有患这种疾病的人因这种疾病而死的比率。换言之,死亡
率就是这种疾病能够使患者丧命的可能性,能够显示出这种疾病的严重性,能够表
明这种疾病作为公共卫生文件的严重程度。患非典型肺炎的患者会不会死于这种疾
病,与如下因素有关:SARS病毒、传染途径、病毒的量、个人身体状况、年龄、基
础疾病以及是否接受了及时的医疗救助。
Many factors complicate efforts to calculate a case fatality ratio while
an outbreak is still evolving. Deaths from SARS typically occur after
several weeks of illness. Full recovery may take even longer. While an
epidemic is still evolving, only some of the individuals affected by the
disease will have died or recovered. Only at the end of an epidemic can
an absolute value be calculated, taking into account total deaths,
total recoveries and people lost to follow-up. Calculating case fatality
as the number of deaths reported divided by the number of cases
reported irrespective of the time elapsed since they became ill gives an
underestimate of the true case fatality ratio.
在疫情还在爆发阶段的时候,有许多因素影响了死亡率计算的准确性。非典型肺炎
患者通常是染病几周后死亡。完全康复需要更长的时间。当一种传染病尚处于发展
阶段的时候,死亡病患与康复的患者只是少数个案。只有在这次疫情结束的时候,
准确的死亡数字和康复数字才能统计出来,只有那时候才能统计出准确的死亡率。
目前的死亡率计算方法是将死亡病例数除以自疾病爆发一来所有发病人数得到的。
这样计算出的死亡率比实际死亡率低得多。
One method of overcoming this difficulty is to calculate the case
fatality ratio using only those cases whose final outcome - died or
recovered - is known. However, this method, when applied before an
outbreak is over, gives an overestimate because the average time from
illness onset to death for SARS is shorter than the average time from
illness onset to recovery.
另一个计算方法,可以克服上述的缺点,就是用死亡人数除以已知死亡人数和康复
人数之和。但是这种算法在爆发期结束之前的结果比实际死亡率高出许多,因为通
常情况治痊非典型肺炎的时间比非典患者死亡时间要长。
With these methods, estimates of the case fatality ratio range from
11% to 17% in Hong Kong, from 13% to 15% in Singapore, from 15% to 19%
in Canada, and from 5% to 13% in China.
根据以上两种方法,综合估算出的死亡率具体数值如下:香港11%-17%,新加坡
13%-15%,加拿大15%-19%,中国5%-13%,
A more accurate and unbiased estimation of case fatality for SARS can be
obtained with a third method, survival analysis. This method relies
on detailed individual data on the time from illness onset to death or
full recovery, or time since illness onset for current cases. Using this
method, WHO estimates that the case fatality ratio is 14% in
Singapore and 15% in Hong Kong.
计算非典型肺炎的死亡率有更加准确,更加客观的第三种方法。这种计算方法选择
从发病到死亡或康复的时间或目前的病例开始发病的时间内具体每个数据。用这种
方法,世界卫生组织计算出新加坡死亡率是14%,香港死亡率15%,
In Viet Nam, where SARS has been contained and measurement is more
straightforward, case fatality was comparatively low, at 8%. One
explanation for this is the large number of total cases that occurred in
younger, previously healthy health care workers.
越南的非典型肺炎疫情已经结束,一次那里的死亡率计算更加容易。越南的死亡率
相对比较低,只有8%。比较合理的解释是越南的病例年龄普遍偏低,并且医务人
员感染较多。
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