Evaluation of comorbidities and health care resource use among patients with highly active neuromyelitis optica
Evaluation of comorbidities and health care resource use among patients with highly active neuromyelitis optica
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DOI：
10.1016/j.jns.2017.11.022
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发表时间：
2018-01-15
影响因子：
4.4
通讯作者：
Levy, Michael
中科院分区：
文献类型：
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作者：
Ajmera, Mayank R.;Boscoe, Audra;Levy, Michael
背景资料：视神经肌萎缩症（NMO）的特点是视神经和脊髓受到不可预测的攻击，导致神经功能障碍的积累，可能导致失明和瘫痪。我们检查了高度活跃的NMO患者的合并症和医疗保健使用情况，定义为患者在数据库中首次遇到NMO后12个月内至少复发两次。方法：这项对美国行政索赔数据库的回顾性研究比较了高度活跃的NMO患者与没有NMO的匹配个体。所有的结果，包括Charlson Comorbid指数（CCI）评分，住院治疗，急诊科就诊，在12个月内进行测量后，患者的第一次NMO遇到在database.Results：共1349例NMO被确定。其中，134例具有高度活跃的NMO（80%为女性，平均年龄45.6岁），并与670例非NMO对照组相匹配。高活动性NMO患者的合并症负担显著高于非NMO对照组（平均CCI评分：4.1 vs 0.6; P < 0.0001）和住院比例更高（53.7%对4.0%; P < 0.0001）和急诊科就诊结论：多种急性和慢性疾病的高发生率以及广泛的医疗保健使用突出了高活动性NMO患者的显著医疗负担。
Background: Neuromyelitis optica (NMO) is characterized by unpredictable attacks on the optic nerves and spinal cord, causing accumulations of neurological disability that may lead to blindness and paralysis. We examined comorbidities and health care use among patients with highly active NMO, defined as at least two relapses within 12 months of the patient's first NMO encounter in the database.Methods: This retrospective study of a US administrative claims database compared patients with highly active NMO to matched individuals without NMO. All outcomes, including Charlson Comorbidity Index (CCI) score, hospitalizations, and emergency department visits, were measured over the 12-month period following the patient's first NMO encounter in the database.Results: A total of 1349 patients with NMO were identified. Of these, 134 had highly active NMO (80% female, mean age 45.6 years) and were matched to 670 non-NMO controls. Patients with highly active NMO had significantly greater comorbidity burden than non-NMO controls (mean CCI score: 4.1 versus 0.6; P < 0.0001) and greater proportions of hospitalization (53.7% versus 4.0%; P < 0.0001) and emergency department visits (60.5% versus 9.7%; P < 0.0001).Conclusions: High occurrence of several acute and chronic conditions and extensive health care use highlight the significant medical burden among patients with highly active NMO.