Age-related features of morbidity and disability in diseases of the digestive system in the adult population of St. Petersburg in dynamics for 2013-2021

Authors:

Kantemirova Raisa Kantemirova — Honored Doctor of the Russian Federation, Grand PhD in Medical sciences (Dr. Med. Sci.), Head of the Adult Department of Somatic Rehabilitation of the Clinic, Head of the Department of Therapy of the Institute of Additional Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; Professor of the Department of Hospital Therapy of the Faculty of Medicine, St. Petersburg State University, 7-9 Universitetskaya Emb., 199034 St. Petersburg, Russian Federation; e-mail: terapium@yandex.ru; https://orcid.org/0000-0002-1287-486X.

Fidarova Zalina Danilovna — PhD in Medical sciences (Cand. Med. Sci.), Associate Professor of Department of Therapy of the Institute of Additional Professional Education, doctor of Adult Department of Somatic Rehabilitation of the Clinic, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; zalina-fidarova@yandex.ru.

Chernyakina Tatiana Sergeevna — Grand PhD in Medical sciences (Dr. Med. Sci.), Professor, Chief Researcher of the Department of Monitoring the Observance of the Rights of Persons with Disabilities of Institute of Rehabilitation and Habilitation of the Disabled, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; Professor of the Department of Preventive Medicine and Health Protection, North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of Russia, 47 Piskarevsky Ave., 195067 St. Petersburg, Russian Federation; e-mail: maimulovt@mail.ru; https://orcid.org/0000-0002-2854-3248.

Zalnova Irina Aleksandrovna — Head of the Department of Hospitalization, doctor-therapist, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: irinazalnova@mail.ru.

Serdyukov Sergey Viktorovich — PhD in Medical sciences (Cand. Med. Sci.), Associate Professor of the Department of Therapy of the Institute of Additional Professional Education, doctor of Adult Department of Somatic Rehabilitation of the Clinic, Albrecht Federal Scientific and Educational Center of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; Associate Professor of the Department of Hospital Therapy, North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of Russia, 47 Piskarevsky Ave., 195067 St. Petersburg, Russian Federation; serdyukovsv@yandex.ru.

Annotation:

Introduction. Digestive diseases of a non-infectious nature are widespread among the population of various countries of the world, occupy one of the leading places in the structure of the incidence of the population, remain one of the urgent health problems, and have a high social and economic significance. As we age, involutive processes arise that lead to structural and functional changes in the organs of the gastrointestinal tract, which in themselves are not a disease. However, these changes may predispose to the development of pathology in the presence of certain risk factors and comorbidity, in conditions of exposure to a complex of adverse environmental factors on the body, and then lead to disability. In order to take timely measures to prevent morbidity and disability in diseases of the digestive system, including in the older age group, constant monitoring and analysis of relevant indicators is necessary.

Aim. The aim of the study is to study the prevalence of digestive diseases and primary disability among people over the age of 18 living in St. Petersburg in dynamics for 2013-2021.

Materials and methods. A content analysis of the structure and prevalence of diseases of the digestive system and related primary disability, in dynamics for 2013-2021 in persons aged 18 years and older) living in St. Petersburg in comparison with the average Russian indicators, was carried out. The research material is the forms of state statistical observation: “Information on the number of diseases registered in patients living in the service area of a medical organization” for 2013-2021, “Information on the activities of units of a medical organization providing medical care in a hospital” for 2013-2021, “Information on the medical and social examination of persons aged 18 years and older” in St. Petersburg and the Russian Federation.

Results. In St. Petersburg, from 2013 to 2021, the incidence rate for the class “Diseases of the digestive organs” in people 18 years of age and older increased by 76.66% (from 669.55%o in 2013 to 1182.81%o in 2021), while on average in the Russian Federation the prevalence of digestive diseases decreased by 11.38%.
The total number of people with disabilities recognized as disabled for the first time due to digestive diseases was dominated by disabled people with disability group III — from 45 to 60%; the second largest number (36-42%) were persons with severe digestive impairment (disability group II) and the lowest proportion (2.5-12%) were persons with significant digestive impairment (disability group I).

Discussion. Chronic diseases are characterized by a wide prevalence and a long period of morbidity growth among the adult population of St. Petersburg, which is associated with an increase in the number of planned and emergency hospitalizations, surgical interventions performed for diseases of the digestive system. At the same time, the number of complications associated with surgical treatment of diseases of the digestive system decreases. When analyzed in the age aspect, the number of complications and deaths in persons of retirement age is less, in comparison with persons of working age. Liver diseases are characterized by the greatest mortality both in retirement and in working age. The ways to solve the identified problems associated with diseases of the digestive system are in line with measures aimed at primary and secondary prevention of morbidity and disability, which can be carried out by primary care physicians.

Conclusion. A retrospective analysis for 2013-2021 of morbidity and disability in diseases of the digestive organs in residents of St. Petersburg 18 years and older, revealed patterns and differences in dynamics and structure compared with the average Russian indicators, manifested in postoperative complications, mortality and disability.
The results obtained can be used to make managerial decisions at the state level, both federal and regional, on the development of a system of prevention, early diagnosis of diseases of the digestive system and comprehensive rehabilitation of disabled people.

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