Cervical dystonia incidence and diagnostic delay in a multiethnic population.
Cervical dystonia incidence and diagnostic delay in a multiethnic population.
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DOI：
10.1002/mds.27927
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发表时间：
2020-03
影响因子：
8.6
通讯作者：
Tanner, Caroline M.
中科院分区：
文献类型：
--
作者：
LaHue, Sara C.;Albers, Kathleen;Goldman, Samuel;Lo, Raymond;Gu, Zhuqin;Leimpeter, Amethyst;Fross, Robin;Comyns, Kathleen;Marras, Connie;de Kleijn, Annelie;Smit, Robin;Katz, Maya;Ozelius, Laurie J.;Bressman, Susan;Saunders-Pullman, Rachel;Comella, Cynthia;Klingman, Jeffrey;Nelson, Lorene M.;Van Den Eeden, Stephen K.;Tanner, Caroline M.
目前颈肌张力障碍 (CD) 发病率的估计是基于种族相对单一的人群中的少数情况。 CD 延迟诊断的频率和后果尚不清楚。确定大型多民族综合健康维护组织内 CD 发病率并描述 CD 诊断延迟的特征。我们利用电子病历和对 2003 年 1 月 1 日至 2007 年 12 月 31 日期间超过 300 万 Kaiser Permanente 北加州会员的多阶段筛查，确定了 CD 事件病例。最终诊断是由运动障碍专家共识做出的。诊断延迟是通过问卷和健康利用数据来衡量的。假设病例呈泊松分布，对发病率进行估计，并直接根据 2000 年美国人口普查进行标准化。采用多变量逻辑回归模型来评估 CD 之前的诊断和行为，并与匹配的对照进行比较，并调整年龄、性别和会员期限。基于超过 1540 万人年的 200 例病例，CD 发病率为 1.18/100,000 人年（95% 置信区间 [CI]，0.35-2.0；女性，1.81；男性，0.52）。发病率随着年龄的增长而增加。接受采访的克罗恩病患者中有一半报告诊断延迟。在索引日期之前，CD 患者中更常见的诊断包括特发性震颤（比值比 [OR] 68.1；95% CI，28.2–164.5）、颈椎间盘疾病（OR 3.83；95% CI，2.8–5.2）、颈部扭伤/拉伤（OR 2.77；95% CI，1.99–3.62）、焦虑（OR 2.24；95% CI，1.99–3.62）、焦虑（OR 2.24；95% CI，2.8–5.2）。 95% CI, 1.63–3.11) 和抑郁症 （OR 1.94；95% CI，1.4–2.68）。 CD 的发病率在女性中更高，并且随着年龄的增长而增加。诊断延迟很常见，并且与不良反应相关。
Current cervical dystonia (CD) incidence estimates are based on small numbers in relatively ethnically homogenous populations. The frequency and consequences of delayed CD diagnosis is poorly characterized. To determine CD incidence and characterize CD diagnostic delay within a large, multiethnic integrated health maintenance organization. We identified incident CD cases using electronic medical records and multistage screening of more than 3 million Kaiser Permanente Northern California members from January 1, 2003, to December 31, 2007. A final diagnosis was made by movement disorders specialist consensus. Diagnostic delay was measured by questionnaire and health utilization data. Incidence rates were estimated assuming a Poisson distribution of cases and directly standardized to the 2000 U.S. census. Multivariate logistic regression models were employed to assess diagnoses and behaviors preceding CD compared with matched controls, adjusting for age, sex, and membership duration. CD incidence was 1.18/100,000 person-years (95% confidence interval [CI], 0.35–2.0; women, 1.81; men, 0.52) based on 200 cases over 15.4 million person-years. Incidence increased with age. Half of the CD patients interviewed reported diagnostic delay. Diagnoses more common in CD patients before the index date included essential tremor (odds ratio [OR] 68.1; 95% CI, 28.2–164.5), cervical disc disease (OR 3.83; 95% CI, 2.8–5.2), neck sprain/strain (OR 2.77; 95% CI, 1.99–3.62), anxiety (OR 2.24; 95% CI, 1.63–3.11) and depression (OR 1.94; 95% CI, 1.4–2.68). CD incidence is greater in women and increases with age. Diagnostic delay is common and associated with adverse effects.
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影响因子：
8.6
作者：
Asgeirsson, H;Jakobsson, F;Sveinbjornsdottir, S
通讯作者：
Sveinbjornsdottir, S
影响因子：
9.9
作者：
Marras, C.;Van den Eeden, S. K.;Tanner, C. M.
通讯作者：
Tanner, C. M.
影响因子：
2.4
作者：
GOETZ, CG;PAPPERT, EJ
通讯作者：
PAPPERT, EJ
影响因子：
4.1
作者：
Jankovic, J.;Tsui, J.;Bergeron, C.
通讯作者：
Bergeron, C.
影响因子：
8.6
作者：
Fukuda, Hiroki;Kusumi, Masayoshi;Nakashima, Kenji
通讯作者：
Nakashima, Kenji