Projected increase in total knee arthroplasty in the United States - an alternative projection model
Projected increase in total knee arthroplasty in the United States - an alternative projection model
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DOI：
10.1016/j.joca.2017.07.022
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发表时间：
2017-11-01
影响因子：
7
通讯作者：
Nemes, S.
中科院分区：
文献类型：
--
作者：
Inacio, M. C. S.;Paxton, E. W.;Nemes, S.
目的：我们研究的目的是使用保守预测模型（假设手术的最大IR）估计2015年至2050年美国初次全膝关节置换术（TKA）的未来发病率（IR）和数量。此外，我们的研究比较了这些预测模型假设指数增长，在以前的研究中所做的，用于说明purposes.Methods：人口为基础的流行病学研究进行了使用数据从美国国家住院病人样本（NIS）和人口普查局。确定了1993年至2012年期间进行的初次TKA手术。计算每10万名40岁以上美国公民TKA的IR、95%置信区间（CI）或预测区间（PI）。估计的IR用作具有逻辑回归的回归建模的结果（即，保守模型）和泊松回归方程（即，结果：逻辑回归模型表明，与2012年相比，预计到2050年，TKA的IR将增加69%，从2012年的429例（95% CI 374-453）手术/100，000增加到2050年的725例（95% PI 121 e1041）。这意味着TKA手术量预计增加143%。使用泊松模型，2050年的IR预计将增加565%，达到2854（95% CI 2278-4004）例手术/100，000例IR，与2012年相比，预计数量增加855%。结论：即使在使用保守的预测方法后，美国的TKA数量，已经是世界上膝关节置换术IR最高的国家，预计到2050年将增长143%。(C)2017国际骨关节炎研究学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: The purpose of our study was to estimate the future incidence rate (IR) and volume of primary total knee arthroplasty (TKA) in the United States from 2015 to 2050 using a conservative projection model that assumes a maximum IR of procedures. Furthermore, our study compared these projections to a model assuming exponential growth, as done in previous studies, for illustrative purposes.Methods: A population based epidemiological study was conducted using data from US National Inpatient Sample (NIS) and Census Bureau. Primary TKA procedures performed between 1993 and 2012 were identified. The IR, 95% confidence intervals (CI), or prediction intervals (PI) of TKA per 100,000 US citizens over the age of 40 years were calculated. The estimated IR was used as the outcome of a regression modelling with a logistic regression (i.e., conservative model) and Poisson regression equation (i.e., exponential growth model).Results: Logistic regression modelling suggests the IR of TKA is expected to increase 69% by 2050 compared to 2012, from 429 (95% CI 374-453) procedures/100,000 in 2012 to 725 (95% PI 121e1041) in 2050. This translates into a 143% projected increase in TKA volume. Using the Poisson model, the IR in 2050 was projected to increase 565%, to 2854 (95% CI 2278-4004) procedures/100,000 IR, which is an 855% projected increase in volume compared to 2012.Conclusions: Even after using a conservative projection approach, the number of TKAs in the US, which already has the highest IR of knee arthroplasty in the world, is expected to increase 143% by 2050. (C) 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.