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Incidence of hand and wrist disorders in primary care: a retrospective cohort study
Patrick Krastman1, Evelien It de Schepper2, Patrick Je Bindels2
1Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands wetenschap@dezorghoek.nl.
Background:
The incidence of different types of hand and wrist disorders in primary care is unknown since there are no specific encodings for it.
Aim:
To determine the overall incidence and the incidence of specific types of hand and wrist disorders in primary care.
Design & Setting:
A retrospective cohort study was undertaken, using a healthcare registration database from Dutch general practice, which contains medical records of more than 200 000 patients, and included approximately 25% of the population of the area of Rotterdam in The Netherlands.
Method:
Patients aged ≥18 years with a new diagnosis of hand or wrist disorder from 1 January 2015-31 December 2019 were extracted using a search algorithm based on International Classification of Primary Care (ICPC) coding and search terms in free text.
Results:
The mean incidence over the study period of a hand disorder was 5.9 per 1000 persons-years and of a wrist disorder 0.3 per 1000 persons-years. The incidence of trigger finger or thumb, hand or finger fracture, tendon or ligament tendinopathy, mallet finger, and hand or finger ligament injury were 3 (95% confidence interval [CI] = 2.69 to 3.15), 1 (95% CI = 1.03 to 1.33), 1 (95% CI = 0.98 to 1.28), 0.6 (95% CI = 0.48 to 0.69), and 0.1 (95% CI = 0.06 to 0.14) per 1000 persons-years, respectively. The incidence of a wrist fracture and ligament injury were 0.2 (95% CI = 0.13 to 0.25) and 0.1 (95% CI = 0.04 to 0.12) per 1000 persons-years, respectively.
Conclusion:
There is a large difference between the number of patients presenting to the GP with hand and wrist complaints and the number of hand and wrist diagnoses reported in the medical files. Introducing specific ICPC codes for different types of hand and wrist disorders could (potentially) lead to a more accurate registration of a diagnosis and determination of the incidence figures.
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