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Modelação da morbilidade e mortalidade por doenças cardiovasculares na Área Metropolitana de Lisboa
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Resumo(s)
As doenças cardiovasculares são a principal causa de morte à escala mundial, europeia e
portuguesa, estando associadas a fatores modificáveis e não-modificáveis. Estes indicadores
variam de local para local, sendo essencial a identificação dos padrões de prevalência da
doença, e causas associadas. O presente trabalho divide-se em dois principais tópicos.
Primeiramente, procurou-se, através de uma revisão estruturada da literatura académica e
cinzenta, nacional e internacional (aplicando a metodologia PRISMA 2020 na análise), identificar
os principais indicadores, métodos, e limitações apontadas na academia alusivas à temática
das doenças cardiovasculares, assim como as principais políticas definidas pelas entidades
governamentais e não-governamentais. As conclusões retiradas desta análise constituirão na
base para a localização, na Área Metropolitana de Lisboa, das áreas geográficas com maior risco
cardiovascular. Para tal, foram desenvolvidos dois modelos de análise (correlação por quartis
LISA, e análise de risco aplicando uma Análise Multicritério) à escala do hexágono. Na revisão
estruturada, foram identificados 24 fatores de risco, associados a diferentes fatores (estilo de
vida individual; fatores sociodemográficos; fatores ambientais). Foi também denotada quer uma
presença reduzida de artigos com componente analítica espacial, como também a existência de
uma larga percentagem de artigos com unidades de análise pouco detalhadas. Considerando
alguns dos indicadores identificados na revisão estruturada, foram analisadas 50 variáveis,
adotando diferentes métodos analíticos para avaliar a distribuição das variáveis e a sua relação,
modelando o respetivo risco de incidência. Os resultados das análises evidenciam não só uma
diferença urbano-rural no grau de risco, como também uma maior incidência de risco na zona
sul do território. As conclusões permitem avaliar o risco cardiovascular ao nível de unidades
territoriais muito reduzidas, disponibilizando dados finos, às entidades públicas e privadas, para
a tomada de decisões no território com maior rigor, reduzindo a morbilidade e mortalidade por
doenças cardiovasculares nas áreas geográficas de maior risco.
Cardiovascular diseases are the leading cause of death worldwide, in Europe and Portugal, and are associated with modifiable and non-modifiable factors. These indicators differ from place to place, making it essential to identify patterns of disease prevalence and associated causes. This study is divided into two main topics. Firstly, through a structured review of national and international academic and gray literature (applying the PRISMA 2020 methodology in the analysis), we sought to identify the main indicators, methods and limitations pointed out in academia on the subject of cardiovascular disease, as well as the main policies defined by governmental and non-governmental entities. The conclusions drawn from this analysis will be the basis for locating the geographical areas with the highest cardiovascular risk in the Lisbon Metropolitan Area. To this end, two analysis models were developed (correlation by LISA quartiles, and risk analysis by applying a Multicriteria Analysis) on a hexagon scale. In the structured review, 24 risk factors were identified, associated with different factors (individual lifestyle; sociodemographic factors; environmental factors). There were also few articles with a spatial analytical component, and a large percentage of articles with poorly detailed units of analysis. Considering some of the indicators identified in the structured review, 50 variables were analyzed, using different analytical methods to assess the distribution of variables and their relationship, modeling the respective risk of incidence. The results of the analysis show not only an urban-rural difference in the degree of risk, but also a higher incidence of risk in the southern part of the territory. The conclusions make it possible to assess cardiovascular risk at the level of very small territorial units, providing public and private entities with fine-grained data for more rigorous decision-making in the territory, reducing morbidity and mortality from cardiovascular diseases in the geographical areas most at risk.
Cardiovascular diseases are the leading cause of death worldwide, in Europe and Portugal, and are associated with modifiable and non-modifiable factors. These indicators differ from place to place, making it essential to identify patterns of disease prevalence and associated causes. This study is divided into two main topics. Firstly, through a structured review of national and international academic and gray literature (applying the PRISMA 2020 methodology in the analysis), we sought to identify the main indicators, methods and limitations pointed out in academia on the subject of cardiovascular disease, as well as the main policies defined by governmental and non-governmental entities. The conclusions drawn from this analysis will be the basis for locating the geographical areas with the highest cardiovascular risk in the Lisbon Metropolitan Area. To this end, two analysis models were developed (correlation by LISA quartiles, and risk analysis by applying a Multicriteria Analysis) on a hexagon scale. In the structured review, 24 risk factors were identified, associated with different factors (individual lifestyle; sociodemographic factors; environmental factors). There were also few articles with a spatial analytical component, and a large percentage of articles with poorly detailed units of analysis. Considering some of the indicators identified in the structured review, 50 variables were analyzed, using different analytical methods to assess the distribution of variables and their relationship, modeling the respective risk of incidence. The results of the analysis show not only an urban-rural difference in the degree of risk, but also a higher incidence of risk in the southern part of the territory. The conclusions make it possible to assess cardiovascular risk at the level of very small territorial units, providing public and private entities with fine-grained data for more rigorous decision-making in the territory, reducing morbidity and mortality from cardiovascular diseases in the geographical areas most at risk.
Descrição
Palavras-chave
Análise de risco Doenças cardiovasculares Modelação espacial Saúde Sistemas de Informação Geográfica