Assuntos
Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Angina Pectoris/etiologia , Aneurisma Coronário/diagnóstico por imagem , Angiografia Coronária , Eletrocardiografia , Bloqueio Cardíaco/diagnóstico por imagem , Bloqueio Cardíaco/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Doenças Cardiovasculares/etiologia , Falência Renal Crônica/diagnóstico por imagem , Imagem de Perfusão do Miocárdio/efeitos adversos , Purinas/efeitos adversos , Pirazóis/efeitos adversos , Medição de Risco , Tomografia Computadorizada de Emissão de Fóton Único/efeitos adversos , Humanos , Falência Renal Crônica/complicações , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico por imagemRESUMO
Obesity is a growing epidemic, yet few patients with obesity receive a clinical diagnosis of obesity or appropriate counseling. We examined the socioeconomic and demographic factors associated with the accurate diagnosis of obesity during ambulatory care visits. We used data from the National Hospital Ambulatory and National Ambulatory Medical Care Surveys (NHAMCS and NAMCS) to determine if a patient with obesity had been clinically diagnosed with obesity during the visit by either of the following: (1) a diagnosis listed in the patient's record; or (2) the provider's answer to the question "despite the diagnoses listed, does this patient have obesity?" We used multivariate models to examine the association between the accurate diagnosis of obesity and socioeconomic and demographic factors. We examined 885,291,770 weighted office visits involving individuals 5 years of age and older between 2006 and 2010. Providers were less likely to diagnose obesity at office visits involving children (5-12 years) with obesity (23.4 %) than at visits for adolescents (13-21 years; 39.7 %), young adults (22-34 years; 45.4 %), adults (35-64 years; 43.9 %) or elderly adults (≥65 years; 39.6 %; P < 0.001 for all). Individuals with obesity residing in more highly educated areas were more likely to be diagnosed than those living in less highly educated areas (44.2 vs. 40.9 %; AOR 1.4; 95 % CI 1.2-1.6). Males with obesity were less likely to be diagnosed than females with obesity (36.1 vs. 45.8 %; AOR 0.7; 95 % CI 0.6-0.8). After controlling for socioeconomic-status we did not find a consistent difference in the diagnosis of obesity by race. The diagnosis of obesity was made at less than half of all office visits involving patients with obesity. Children, adolescents, elderly, males, and those living in less educated areas were less likely to be accurately diagnosed with obesity.