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Network Analysis of Legg-Calve-Perthes Disease and Its Comorbidities
KyeongMi Kim1, Kyung Rae Ko2, Siyoung Yoon3
1Department of Laboratory Medicine, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang 10414, Republic of Korea.
Insights
Network analysis reveals injury-related conditions and congenital hip deformities are significantly associated with Legg-Calvé-Perthes disease (LCPD) in children. This study enhances understanding of LCPD comorbidities.
Area of Science:
- Pediatric Orthopedics
- Epidemiology
- Medical Informatics
Background:
- Legg-Calvé-Perthes disease (LCPD) involves idiopathic avascular necrosis of the femoral head in children.
- The precise etiology of LCPD remains elusive, necessitating further investigation into contributing factors.
- Comorbidity studies offer valuable insights into the complex nature of LCPD.
Purpose of the Study:
- To conduct a network analysis identifying associations between Legg-Calvé-Perthes disease (LCPD) and its comorbidities.
- To explore potential etiological links and clinical implications through comorbidity profiling.
Main Methods:
- Analysis of pediatric patients (≤12 years) diagnosed with LCPD using ICD-10 codes from a national health insurance database (2002-2015).
- Propensity score matching was employed to establish a control group.
- Network analysis was performed on identified comorbidities, with results visualized using odds ratios.
Main Results:
- Twenty-three significant disease clusters associated with LCPD were identified.
- Injury-related disease clusters (ICD-10 codes starting with 'S') were most prevalent.
- Congenital hip deformities (Q65) exhibited the highest odds ratio, followed by congenital foot deformities (Q66) and other anemia (D64).
Conclusions:
- Network analysis confirms significant associations between LCPD and various comorbidities.
- The identified comorbidity network provides a foundation for future research into the pathogenesis and management of LCPD.
- Understanding these associations may guide diagnostic and therapeutic strategies for pediatric patients with LCPD.
Abstract:
Background/Objectives: Legg-Calvé-Perthes disease (LCPD) is characterized by idiopathic avascular necrosis of the femoral head in children. There are several hypotheses regarding the cause of LCPD; however, the exact cause remains unclear. Studies on comorbidities can provide better insight into the disease. We aimed to perform a network analysis to identify the associations between LCPD and comorbidities. Methods: We analyzed patients aged ≤ 12 years with LCPD as defined by ICD-10 codes M91.1, M91.8, and M91.9 registered in the National Health Insurance Service cohort database from 2002 to 2015. A control group was designed using propensity score matching. Comorbidities were identified and network analysis was performed. The identified comorbidities were reclassified into clinical disease groups considering their clinical relevance, and a network map was created using odds ratios. Results: In total, 23 significant disease clusters were identified. Injury-related disease clusters with ICD-10 codes starting with "S" were the most frequent. They were reclassified into 11 disease groups based on clinical relevance. Among these, congenital deformities of hip (Q65) had the highest odds ratio. Congenital deformities of feet (Q66) and other anemia (D64) had a single association with LCPD in the comorbidity network analysis. Conclusions: We confirmed the association between LCPD and comorbidities using a network analysis. The LCPD comorbidity network identified in this study is expected to serve as the basis for future research on LCPD.
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