原生脊椎骨质炎的发病率和危险因素:使用国家索赔数据库进行的回顾性队列研究
Luke Channer1, Olivia Krol1, Travis Philipp2
1School of Medicine, Oregon Health & Science University, 2730 SW Moody Ave, Portland, OR, 97201.
概括
在过去的十年中,美国本地脊椎骨质炎 (NVO) 的发生率翻了一番. 新的风险因素包括大麻使用,以及兴奋剂使用,类固醇使用,烟草使用和糖尿病.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
背景情况:
- 原生脊椎骨髓炎 (NVO) 由于非特异性症状,延迟诊断和高发病率/死亡率,造成了重大临床挑战.
- 现有的文献缺乏关于导致NVO发生的特定风险因素的全面数据.
研究的目的:
- 为了确定NVO在美国的发病率.
- 通过使用国家索赔数据库,识别与NVO发展相关的特定风险因素.
主要方法:
- 来自PearlDiver数据库 (2010-2020) 的100万名患者记录的回顾性分析.
- 排除先前经过脊髓手术的患者,以隔离NVO风险因素.
- 国际疾病分类 (ICD-9/10) 用于NVO诊断的代码.
- 使用后勤回归和Cox比例危险建模来识别风险因素及其随时间推移的影响.
主要成果:
- 每10万名患者中的NVO发病率为14.69 (2010-2020年).
- 确定了重要的危险因素:兴奋剂使用 (OR 4.03),类风湿关节炎 (OR 2.05),糖尿病 (OR 1.88),大麻使用 (OR 1.72),肥胖 (OR 1.72),烟草使用 (OR 1.68),慢性肝病 (OR 1.63),男性性别 (OR 1.63),类固醇使用 (OR 1.56),滥用酒精 (OR 1.52),骨质疏松症 (OR 1.22).
- 查尔森并发症指数 (CCI) 较高的得分使NVO危险增加了17% (p=.001).
结论:
- 与之前的估计相比,NVO在美国的发病率翻了一番.
- 大麻使用被确定为NVO的新型和重大风险因素.
- 建议使用早期检测算法来缓解与NVO相关的发病率和死亡率.
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