Past and Future Burden of Inflammatory Bowel Diseases Based on Modeling of Population-Based Data
Past and Future Burden of Inflammatory Bowel Diseases Based on Modeling of Population-Based Data
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DOI：
10.1053/j.gastro.2019.01.002
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发表时间：
2019-04-01
期刊：
影响因子：
29.4
通讯作者：
Kaplan, Gilaad G.
中科院分区：
文献类型：
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作者：
Coward, Stephanie;Clement, Fiona;Kaplan, Gilaad G.
背景与目的：炎症性肠病（Inflammatory Bowel Diseases，IBD）在世界范围内普遍存在，其中以北美地区的发病率最高. IBD是复杂和昂贵的，其日益增加的患病率对卫生保健系统造成了更大的压力。我们的目的是确定IBD在加拿大的过去、现在和未来的患病率。方法：我们使用来自阿尔伯塔省（2002-2015）、不列颠哥伦比亚省（1997-2014）、马尼托巴省（1990-2013）、新斯科舍省（1996-2009）、安大略省（1999-2014）、魁北克省（2001-2008）和萨斯喀彻温省（1998-2016）的基于人群的卫生管理数据进行了一项回顾性队列研究。应用自回归综合移动平均回归，预测到2030年的患病率，预测区间为95%。采用对数二项回归评估了平均年百分比变化，95%置信区间。研究结果：2018年，加拿大IBD的患病率估计为每10万人725例（95% PI 716-735），年平均百分比变化估计为2.86%（95%置信区间2.80%-2.92%）。预计2030年的患病率为每10万人981人（95% PI 963-999）：儿童159/100，000（95% PI 133-185），成人1118/100，000（95% PI 1069-1168），老年人1370/100，000（95% PI 1312-1429）。2018年，估计有267，983名加拿大人（95% PI 264，579 - 271，387）患有IBD，预计到2030年将增加到402，853人（95% PI 395，466 - 410，240）。结论：预测流行率将使卫生政策制定者能够制定必要的政策，以应对卫生系统在提供高质量和具有成本效益的护理方面面临的挑战。
BACKGROUND & AIMS: Inflammatory bowel diseases (IBDs) exist worldwide, with high prevalence in North America. IBD is complex and costly, and its increasing prevalence places a greater stress on health care systems. We aimed to determine the past current, and future prevalences of IBD in Canada. METHODS: We performed a retrospective cohort study using population-based health administrative data from Alberta (2002-2015), British Columbia (1997-2014), Manitoba (1990-2013), Nova Scotia (1996-2009), Ontario (1999-2014), Quebec (2001-2008), and Saskatchewan (1998-2016). Autoregressive integrated moving average regression was applied, and prevalence, with 95% prediction intervals (PIs), was forecasted to 2030. Average annual percentage change, with 95% confidence intervals, was assessed with log binomial regression. RESULTS: In 2018, the prevalence of IBD in Canada was estimated at 725 per 100,000 (95% PI 716-735) and annual average percent change was estimated at 2.86% (95% confidence interval 2.80%-2.92%). The prevalence in 2030 was forecasted to be 981 per 100,000 (95% PI 963-999): 159 per 100,000 (95% PI 133-185) in children, 1118 per 100,000 (95% PI 1069-1168) in adults, and 1370 per 100,000 (95% PI 1312-1429) in the elderly. In 2018, 267,983 Canadians (95% PI 264,579-271,387) were estimated to be living with IBD, which was forecasted to increase to 402,853 (95% PI 395,466-410,240) by 2030. CONCLUSION: Forecasting prevalence will allow health policy makers to develop policy that is necessary to address the challenges faced by health systems in providing high-quality and cost-effective care.