The Demographics and Epidemiology of Infantile, Juvenile, and Adolescent Idiopathic Scoliosis in a Southern California Integrated Health Care System
The Demographics and Epidemiology of Infantile, Juvenile, and Adolescent Idiopathic Scoliosis in a Southern California Integrated Health Care System
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DOI：
10.1097/brs.0000000000004046
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发表时间：
2021-11-01
期刊：
影响因子：
3
通讯作者：
Kessler, Jeffrey
中科院分区：
文献类型：
--
作者：
Bondar, Kevin;Nguyen, Annie;Kessler, Jeffrey
研究设计。预后研究，III 级。目标。本研究的目的是确定南加州综合医疗保健系统中一大群儿童中特发性脊柱侧凸 (IS) 的发病率和人口统计数据，并确定与 IS 最大风险相关的人口统计或临床因素。背景数据摘要。尽管许多作者报道了儿童 IS 的发病率和患病率，但在美国，针对大量独立人群的发病率研究却很少。方法。我们对 2013 年全年综合医疗保健系统内 18 岁以下患者中诊断出的 IS 病例进行了回顾性图表分析。记录患者人口统计数据并确定 IS 的发生率。使用逻辑回归模型确定具有 IS 和基于人口统计学的更严重初始曲线幅度的优势比 (OR)。 结果。婴儿组、少年组和青少年组的 IS 发病率分别为每 10 万人 3.9 例、28.6 例和 393 例。在所有年龄段中，女性发病率是男性的两倍以上。多变量逻辑回归分析显示，亚洲人和非西班牙裔白人的 IS 的 OR 最高（OR 1.54 和 1.32，95% 置信区间 [CI] 1.33-1.79 和 1.19-1.47）。白人、黑人和混血患者的初始曲线幅度明显高于西班牙裔；女性的初始曲线幅度也明显大于男孩（18.1 度 vs. 16.7 度）。与正常体重相比，体重不足的患者 IS 的 OR 增加了 50%（95% CI 1.16-1.94），并且随着体重的增加，IS 的 OR 逐渐降低。结论。我们对大型综合医疗保健系统的研究揭示了 IS 的发病率和基于体重、性别和民族/种族的 OR。总体发病率总体低于之前的预期。
Study Design. Prognostic study, Level III.Objectives. The aim of this study was to determine the incidence and demographics of idiopathic scoliosis (IS) in a large cohort of children in a Southern California integrated healthcare system, and to identify the demographic or clinical factors associated with the greatest risk of IS.Summary of Background Data. Although many authors have reported on the incidence and prevalence of IS in children, there have been few incidence studies in the United States on large, self-contained populations.Methods. A retrospective chart analysis was done on diagnosed cases of IS within our integrated health care system in patients under age 18 years during the entire 2013 calendar year. Patient demographics were recorded and the incidence of IS was determined. Odds ratios (ORs) for having IS and for having more severe initial curve magnitudes based on demographics were determined using logistic regression models.Results. IS Incidence was 3.9, 28.6, and 393 per 100,000, respectively, for the infantile, juvenile, and adolescent group. The female incidence was more than twice that of males in all age groups. Multivariate logistic regression analysis showed Asians and non-Hispanic Whites had the highest OR of IS (OR 1.54 and 1.32 with 95% confidence interval [CI] 1.33-1.79 and 1.19-1.47). Whites, Blacks, and mixed-race patients had a significantly higher initial curve magnitude than Hispanics; females also had a significantly greater initial curve magnitude than boys (18.1 degrees vs. 16.7 degrees). Underweight patients had a 50% increased OR of IS versus normal weight (95% CI 1.16-1.94) with a progressively decreased OR of IS as weight increased.Conclusion. Our study of a large integrated healthcare system sheds light on the incidence of IS and the ORs based on weight, sex, and ethnicity/race. The overall incidence was lower overall than previously thought.