Trends in the Epidemiology of Osteomyelitis A Population-Based Study, 1969 to 2009
Trends in the Epidemiology of Osteomyelitis A Population-Based Study, 1969 to 2009
复制标题
DOI：
10.2106/jbjs.n.01350
复制
发表时间：
2015-05-20
影响因子：
5.3
通讯作者：
Huddleston, Paul M., III
中科院分区：
文献类型：
--
作者：
Kremers, Hilal Maradit;Nwojo, Macaulay E.;Huddleston, Paul M., III
背景：美国骨髓炎的流行病学情况在很大程度上不为人知。本研究的目的是确定在以人群为基础的环境中骨髓炎发病率的长期长期变化趋势。
方法：研究人群包括1969年1月1日至2009年12月31日期间在明尼苏达州奥姆斯特德县居民中首次确诊的760例骨髓炎发病病例。对每个潜在受试者的完整医疗记录进行了审查，以确认骨髓炎诊断，并提取有关解剖部位、感染病原体、病因风险因素和结果的详细信息。
结果：骨髓炎总体年龄和性别调整后的年发病率为每10万人 - 年21.8例。男性的年发病率高于女性，且随年龄增长而增加（p < 0.001）。发病率随日历年增加（p < 0.001），从1969年至1979年期间的每10万人 - 年11.4例增加到2000年至2009年期间的每10万人 - 年24.4例。儿童和年轻人的发病率相对稳定，但在60岁以上的人群中几乎增加了两倍；这在一定程度上是由糖尿病相关骨髓炎的显著增加所驱动，从1969年至1979年期间的每10万人 - 年2.3例增加到2000年至2009年期间的每10万人 - 年7.6例（p < 0.001）。44%的病例涉及金黄色葡萄球菌感染。
结论：1969年至2009年期间骨髓炎发病率增加的原因尚不清楚，但可能包括多种因素，包括诊断模式的变化或该人群中风险因素（例如糖尿病）患病率的增加。
Background: The epidemiology of osteomyelitis in the United States is largely unknown. The purpose of this study was to determine long-term secular trends in the incidence of osteomyelitis in a population-based setting.Methods: The study population comprised 760 incident cases of osteomyelitis first diagnosed between January 1, 1969, and December 31, 2009, among residents of Olmsted County, Minnesota. The complete medical records for each potential subject were reviewed to confirm the osteomyelitis diagnosis and to extract details on anatomical sites, infecting organisms, etiological risk factors, and outcomes.Results: The overall age and sex-adjusted annual incidence of osteomyelitis was 21.8 cases per 100,000 person-years. The annual incidence was higher for men than for women and increased with age (p < 0.001). Rates increased with the calendar year (p < 0.001) from 11.4 cases per 100,000 person-years in the period from 1969 to 1979 to 24.4 per 100,000 person-years in the period from 2000 to 2009. The incidence remained relatively stable among children and young adults but almost tripled among individuals older than sixty years; this was partly driven by a significant increase in diabetes-related osteomyelitis from 2.3 cases per 100,000 person-years in the period from 1969 to 1979 to 7.6 cases per 100,000 person-years in the period from 2000 to 2009 (p < 0.001). Forty-four percent of cases involved Staphylococcus aureus infections.Conclusions: The reasons for the increase in osteomyelitis between 1969 and 2009 are unclear but could comprise a variety of factors, including changes in diagnosing patterns or increases in the prevalence of risk factors (e.g., diabetes) in this population.