在第一个脱髓化事件发生前20年,医疗保健的使用率较高,并且因年龄和性别而异
Helen Tremlett1, Feng Zhu1, Karl Everett2
1Faculty of Medicine (Neurology), and the Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.
Annals of clinical and translational neurology
|January 31, 2025
概括
在多发性硬化症 (MS) 患者在诊断前28年内,医疗保健的使用量显著增加,在发病前几年急剧升级. 这种模式在男性和老年人中更为明显.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在多发性硬化症 (MS) 诊断之前,医疗保健利用率提高表明早期识别的潜力.
- 然而,在诊断前使用医疗保健的时间模式和社会人口统计学变化仍然不完全理解.
研究的目的:
- 调查MS发病前几十年的医疗保健利用率和时间.
- 为了检查这些模式如何因年龄和性别而异.
主要方法:
- 利用了来自安大略省,加拿大和瑞典 (1991-2020) 的行政健康数据,包括瑞典MS注册表队列.
- 使用诊断代码定义MS发作或报告的症状发作.
- 与患有多发性硬化症 (PwMS) 个体之间的年度医疗保健使用 (医院,医生,急诊室) 的比较以及使用负二项式回归的匹配人口对照,按年龄和性别分层.
主要成果:
- 与对照组相比,PwMS在安大略省的28年和瑞典的15年内使用医疗保健的比例更高.
- 随着MS发病的临近,使用率稳步增加,在诊断前6-7年显著升级,并在诊断前的一年达到顶峰.
- 在男性和老年人中,预发性医疗保健使用率不成比例地高,特别是在诊断前一年.
结论:
- 在MS发病数十年之前,医疗保健使用的显著增加是可观察到的,在6-7年前显著升级.
- 这些诊断前医疗保健利用模式在男性和老年人中更为明显.
- 调查结果突出显示,在MS之前,医疗保健参与度增加了很长一段时间,为早期检测策略提供了潜在的途径.
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