Achalasia: incidence, prevalence and survival. A population-based study
Achalasia: incidence, prevalence and survival. A population-based study
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DOI：
10.1111/j.1365-2982.2010.01511.x
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发表时间：
2010-09-01
影响因子：
3.5
通讯作者：
Svenson, L. W.
中科院分区：
文献类型：
--
作者：
Sadowski, D. C.;Ackah, F.;Svenson, L. W.
背景对贲门失弛缓症流行病学的研究很重要，因为它们常常能对疾病病因学产生新的见解。在这项研究中，我们的目标是利用政府行政数据库开展第一个基于北美人群的贲门失弛缓症流行病学研究。方法加拿大阿尔伯塔省的所有居民都享受全民医疗保险作为福利。阿尔伯塔省卫生与健康部负责维护一个包含患者人口统计信息和医生账单索赔的中央利益相关者数据库。我们将贲门失弛缓症病例定义为 1996-2007 年提交的账单索赔，其 ICD-9-CM 代码为 530.0 或 530，加拿大程序治疗分类代码为 54.92A（内镜球囊扩张）或 54.6（食管肌切开术）。病例定义的初步验证研究表明，已知病例和对照的敏感性为 85%，特异性为 99%。 主要结果 1995 年至 2008 年期间，共鉴定了 463 例贲门失弛缓症病例（59.6% 为男性）。诊断时的平均年龄为 53.1 岁。 2007年，贲门失弛缓症发病率为1.63/10万（95% CI 1.20，2.06），患病率为10.82/10万（95% CI 9.70，11.93）。我们观察到总体患病率从 1996 年的 2.51/100 000 稳步上升到 2007 年的 10.82/100 000。贲门失弛缓症病例的生存率显着低于年龄-性别匹配的人群对照（P < 0.0001）。结论与推论使用基于人群的方法，治疗贲门失弛缓症的发病率和患病率是分别为 1.63/100 000 和 10.82/100 000。该疾病的发病率似乎稳定，但患病率不断上升。贲门失弛缓症病例的存活率明显低于年龄匹配的健康对照。
BackgroundStudies of achalasia epidemiology are important as they often yield new insights into disease etiology. In this study, our objective was to carry out the first North American population-based study of achalasia epidemiology using a governmental administrative database.MethodsAll residents in the province of Alberta, Canada receive universal healthcare coverage as a benefit. The provincial health ministry, Alberta Health and Wellness, maintains a central stakeholder database of patient demographic information and physician billing claims. We defined an achalasia case as a billing claim submitted for the years 1996-2007 with an ICD-9-CM code of 530.0 or 530 and a Canadian Classification of Procedure treatment code of 54.92A (endoscopic balloon dilation) or 54.6 (esophagomyotomy). A preliminary validation study of the case definition demonstrated a sensitivity of 85% and specificity of 99% for known cases and controls.Key ResultsA total of 463 achalasia cases were identified from 1995 to 2008 (59.6% males). Mean age at diagnosis was 53.1 years. In 2007, the achalasia incidence was 1.63/100 000 (95% CI 1.20, 2.06) and the prevalence was 10.82/100 000 (95% CI 9.70, 11.93). We observed a steady increase in the overall prevalence rate from 2.51/100 000 in 1996 to 10.82/100 000 in 2007. Survival of achalasia cases was significantly less than age-sex matched population controls (P < 0.0001).Conclusions & InferencesUsing a population-based approach, the incidence and prevalence of treated achalasia is 1.63/100 000 and 10.82/100 000, respectively. The disease appears to have a stable incidence but a rising prevalence. Survival of achalasia cases is significantly less than age-matched healthy controls.