The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK
The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK
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DOI：
10.1093/brain/123.4.665
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发表时间：
2000-04-01
期刊：
影响因子：
14.5
通讯作者：
Shorvon, SD
中科院分区：
文献类型：
--
作者：
MacDonald, BK;Cockerell, OC;Shorvon, SD
在 18 个月的时间里，通过与国家神经病学和神经外科医院的全科诊所联系计划，在伦敦地区 13 个全科诊所的未经选择的城市人群中前瞻性地确定了所有神经系统疾病的病例。在其中三个实践中，还评估了神经系统疾病的终生患病率。对参与全科医疗登记的 100 230 名患者进行了前瞻性随访，了解神经系统疾病的发生情况。使用多种病例发现方法来保持准确性。计算了年龄和性别调整后的神经系统疾病的发病率。对 27 658 名患者的终生神经系统疾病患病率进行了调查。计算了主要神经系统疾病的年龄和性别调整后的发病率。 [这些以每年每 10 万人的比率表示，括号内为 95% 置信区间 (CI)]。其中最常见的是首次脑血管事件，205 (CI: 183, 230)；带状疱疹，140（CI：104、184）；糖尿病性多发性神经病，54 (CI: 33, 83)；压迫性神经病，49 (CI: 39, 61)；癫痫，46（CI：36、60）；帕金森病，19（CI：12、27）；周围神经病变，15（CI：9、23）；中枢神经系统感染，12（CI：5、13）；带状疱疹后神经痛，11 (CI: 6, 17)；和严重神经损伤，10 (CI: 4, 11)。还报告了终生患病率（以每 1000 人中的比率表示，置信区间为 95%）。最常见的情况是：完全中风，9（CI：8、11）；短暂性脑缺血发作，5（CI：4、6）；活动性癫痫，4（CI：4、5）；先天性神经功能缺损，3（CI：3, 4）；帕金森病，2（CI：1、3）；多发性硬化症，2（CI：2、3）；糖尿病性多发性神经病，2（CI：1、3）；压迫性单神经病，2（CI：2、3）；和蛛网膜下腔出血，1 (CI: 0.8, 2)。总体而言，每年每 10 万人中观察到 625 种神经系统疾病的发病率。百分之六的人口曾患有神经系统疾病。这是近年来第一项针对神经系统疾病的发病率和终生患病率的研究；我们发现这些疾病在社区中引起显着的发病率。
Over an 18-month period, all incident cases of neurological disorders were ascertained prospectively in an unselected urban population based in 13 general practices in the London area by a General Practice Linkage Scheme with the National Hospital for Neurology and Neurosurgery. In three of these practices, the lifetime prevalence of neurological disorders was also assessed. A population of 100 230 patients registered with participating general practices was followed prospectively for the onset of neurological disorders. Multiple methods of case finding were used to maintain accuracy. The age- and sex-adjusted incidence rates of neurological disorders were calculated. The lifetime prevalence of neurological disorders was surveyed in 27 658 of the patients. The age- and sex-adjusted incidence rates were calculated for major neurological conditions. [These are expressed as rates per 100 000 persons per annum, with 95% confidence intervals (CI) in parentheses]. The commonest of these were first cerebrovascular events, 205 (CI: 183, 230); shingles, 140 (CI: 104, 184); diabetic polyneuropathy, 54 (CI: 33, 83); compressive neuropathies, 49 (CI: 39, 61); epilepsy, 46 (CI: 36, 60); Parkinson's disease, 19 (CI: 12, 27); peripheral neuropathies, 15 (CI: 9, 23); CNS infections, 12 (CI: 5, 13); post-herpetic neuralgia, 11 (CI: 6, 17); and major neurological injuries, 10 (CI: 4, 11). Lifetime prevalence rates are also reported (expressed as rate per 1000 persons with 95% CI). The most prevalent conditions were: completed stroke, 9 (CI: 8, 11); transient ischaemic attacks, 5 (CI: 4, 6); active epilepsy, 4 (CI: 4, 5); congenital neurological deficit, 3 (CI: 3, 4); Parkinson's disease, 2 (CI: 1, 3); multiple sclerosis, 2 (CI: 2, 3); diabetic polyneuropathy, 2 (CI: 1, 3); compressive mononeuropathies, 2 (CI: 2, 3); and sub-arachnoid haemorrhage, 1 (CI: 0.8, 2). Overall, the onset of 625 neurological disorders was observed per 100 000 population annually. Six percent of the population had at some time had a neurological disorder. This is the first study of the incidence and lifetime prevalence of neurological disorders in recent times; we found that these disorders give rise to significant morbidity in the community.