Spinal stenosis surgery in Sweden 1987-1999
Spinal stenosis surgery in Sweden 1987-1999
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DOI：
10.1007/s00586-003-0544-9
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发表时间：
2003-10-01
影响因子：
2.8
通讯作者：
Németh, G
中科院分区：
文献类型：
--
作者：
Jansson, KÅ;Blomqvist, P;Németh, G
尽管多年来被认为是一种临床诊断，但椎管狭窄的确切定义尚未达成一致，这导致在解释和比较发病率，患病率和治疗的研究方面存在困难。本研究首次对报告的国家数据进行了分析。这是一项以人群为基础的回顾性国家登记研究，旨在分析腰椎管狭窄患者的手术干预、患者特征、随后的发展和病死率，研究基于1987-1999年瑞典国家数据。通过国家住院登记和瑞典死亡登记的联系，获得了椎管狭窄手术的发生率和类型、多次手术率、死亡率、潜在死亡原因、住院时间和病死率的完整随访数据。该研究队列包括10494名患者。89%的患者行椎板切除术，11%的患者行额外融合。每年平均手术率为每10万居民9.7例，每年进行的手术次数从每10万居民4.7例增加到13.2例。术后30天内病死率为每1000例手术3.5例。心血管疾病是最常见的死亡原因（46%）。入院30天内死亡的相对风险在男性和融合手术中增加了一倍，在80岁以上的患者中增加了4倍。在研究期间，死亡的相对风险降低了。结果表明，椎管狭窄手术在瑞典有所增加，并且与低风险相关。在老年患者群体中，死亡率有所下降。
Despite being recognised for many years as a clinical diagnosis, no exact definition of spinal stenosis has yet been agreed, leading to difficulties in interpreting and comparing studies of the incidence, prevalence and treatment. This study presents the first analysis of national data to be reported. It is a retrospective population-based national register study, aimed at analyzing surgical interventions in patients with lumbar spinal stenosis, patient characteristics, subsequent development, and case fatality rate, based on Swedish national data for 1987-1999. Complete follow-up data were obtained of incidence and type of spinal stenosis surgery, rate of multiple operations, mortality, underlying causes of death, length of hospital stay, and case fatality rate by linkage of the National Inpatient Register and Swedish Death Register. The study cohort consisted of 10,494 patients. Laminectomy was performed in 89%, and additional fusion in 11%. The mean annual rate of operations was 9.7 per 100,000 inhabitants, the annual number of operations performed increased from 4.7 to 13.2 per 100,000 inhabitants per year. The case fatality rate within 30 days after surgery was 3.5 per 1000 operations. Cardiovascular disease was the most common cause of death (46%). Relative risk of dying within 30 days of admission was doubled in men, and for fusion surgery, and increased four fold in patients older than 80 years. The relative risk of dying decreased during the study period. The results show that spinal stenosis surgery in Sweden has increased, and is associated with a low risk. Within an ageing group of patients, mortality has declined.