Prevalence and causes of dysphonia in a large treatment-seeking population
Prevalence and causes of dysphonia in a large treatment-seeking population
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DOI：
10.1002/lary.22426
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发表时间：
2012-02-01
期刊：
影响因子：
2.6
通讯作者：
Courey, Mark
中科院分区：
文献类型：
--
作者：
Cohen, Seth M.;Kim, Jaewhan;Courey, Mark
目的/假设：确定初级保健医生（PCP）和耳鼻喉科医生诊断的发音困难的患病率和常见原因，并评估这些提供者提供的病因学差异。研究设计：回顾性分析来自一个大型的、全国性的美国行政机构的数据。S.索赔数据库。研究方法：根据2004年1月1日至2008年12月31日的国际疾病分类第九版临床修改代码，将患者确定为发声困难。收集有关年龄、性别、地理位置和提供发音障碍诊断的医生类型的数据。计算了总体和年龄相关的患病率，以及按提供者类型划分的特定病因的频率。结果如下：在数据库中的近5500万人中，536，943名患者（年龄0至> 65岁）被诊断为发声障碍（点患病率为0.98%）。女性的患病率高于男性（1.2%对0.7%），70岁以上的人患病率也高于男性（2.5%）。最常见的诊断是急性喉炎、非特异性发音困难、良性声带病变和慢性喉炎。PCP更常诊断为急性喉炎，而耳鼻喉科医生更常诊断为非特异性发音困难和喉部病理。与PCP相比，耳鼻喉科医生更常将胃食管反流诊断为共病。在这一寻求治疗的人群中，喉癌的总患病率为2.2%，在70岁以上的男性中最高。结论：这项对来自全国代表性数据库的保险索赔数据的分析是同类研究中规模最大的。我们发现了与年龄、性别、诊断和医生类型相关的发音困难患病率的重要差异。
Objectives/Hypothesis: To determine the prevalence and common causes of dysphonia as diagnosed by primary care physicians (PCPs) and otolaryngologists and to evaluate differences in etiologies offered by these providers. Study Design: Retrospective analysis of data from a large, nationally representative administrative U. S. claims database. Methods: Patients were identified as dysphonic based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004, to December 31, 2008. Data regarding age, sex, geographic location, and type of physician providing the dysphonia diagnosis were collected. Overall and age-related prevalence rates, as well as frequency of specific etiologies by provider type, were calculated. Results: Of the almost 55 million individuals in the database, 536,943 patients (ages 0 to > 65 years) were given a dysphonia diagnosis (point prevalence rate of 0.98%). The prevalence rate was higher among females as compared to males (1.2% vs. 0.7%) and among those > 70 years of age (2.5%). The most frequent diagnoses overall were acute laryngitis, nonspecific dysphonia, benign vocal fold lesions, and chronic laryngitis. PCPs more commonly diagnosed acute laryngitis, whereas otolaryngologists more commonly diagnosed nonspecific dysphonia and laryngeal pathology. Gastroesophageal reflux was more commonly diagnosed as a comorbid condition by otolaryngologists than by PCPs. Overall laryngeal cancer prevalence in this treatment-seeking population was 2.2% and was greatest among males > 70 years of age. Conclusions: This analysis of insurance claims data from a nationally representative database represents the largest study of its kind. Important differences in dysphonia prevalence related to age, sex, diagnosis, and physician type were identified.