Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States.
Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States.
复制标题
DOI：
10.1186/1471-2474-15-4
复制
发表时间：
2014-01-08
影响因子：
2.3
通讯作者：
Katz JN
中科院分区：
文献类型：
--
作者：
Jain NB;Higgins LD;Losina E;Collins J;Blazar PE;Katz JN
上肢肌肉骨骼疾病是患者寻求治疗和接受门诊手术的常见原因。我们研究的目的是评估美国肩袖修复术、肩关节镜除肩袖修复术、腕管松解术和腕关节镜除腕管松解术外的指征的总体使用率和年龄调整利用率。我们还比较了这些手术的人口统计学、适应症和手术室时间。我们使用2006年全国门诊外科调查来估计2006年在美国进行的感兴趣的手术的数量。我们将这些数据与2006年美国人口普查局的人口规模估计值结合起来，计算出每万人的比率。估计272,148(95%可信区间( = )218,994,325,302)肩袖修复，257,541(95%CI = 185,268,329,814)肩关节镜检查(不包括袖带修复)，576,924(95%CI = 459,239,694,609)腕管松解，25,250(95%CI = 17,304，33,196)腕关节镜检查(不包括腕管松解)。总体而言，腕管松解术的使用率最高(45岁-年龄组每万人37.3人；65-74岁年龄组每万人38.7人；75岁及以上年龄组每万人44.2人)。在接受肩袖修复的人中，65-74岁年龄组的使用率最高(每10,000人28.3人)。非袖带修复相关肩关节镜检查最常见的适应症是撞击综合征、关节炎、滑囊炎和不稳定/拍打撕裂。非腕管松解相关的腕关节镜最常用于韧带扭伤，诊断性关节镜检查用于疼痛和关节软骨疾病。我们的数据显示，在这些常用的上肢非卧床手术的使用上，年龄和人口统计学上有很大的差异。虽然进行了100多万例感兴趣的上肢手术，但这些手术的循证临床适应症仍不明确。
Musculoskeletal disorders of the upper extremity are common reasons for patients to seek care and undergo ambulatory surgery. The objective of our study was to assess the overall and age-adjusted utilization rates of rotator cuff repair, shoulder arthroscopy performed for indications other than rotator cuff repair, carpal tunnel release, and wrist arthroscopy performed for indications other than carpal tunnel release in the United States. We also compared demographics, indications, and operating room time for these procedures. We used the 2006 National Survey of Ambulatory Surgery to estimate the number of procedures of interest performed in the United States in 2006. We combined these data with population size estimates from the 2006 U.S. Census Bureau to calculate rates per 10,000 persons. An estimated 272,148 (95% confidence intervals (CI) = 218,994, 325,302) rotator cuff repairs, 257,541 (95% CI = 185,268, 329,814) shoulder arthroscopies excluding those for cuff repairs, 576,924 (95% CI = 459,239, 694,609) carpal tunnel releases, and 25,250 (95% CI = 17,304, 33,196) wrist arthroscopies excluding those for carpal tunnel release were performed. Overall, carpal tunnel release had the highest utilization rate (37.3 per 10,000 persons in persons of age 45–64 years; 38.7 per 10,000 persons in 65–74 year olds, and; 44.2 per 10,000 persons in the age-group 75 years and older). Among those undergoing rotator cuff repairs, those in the age-group 65–74 had the highest utilization (28.3 per 10,000 persons). The most common indications for non-cuff repair related shoulder arthroscopy were impingement syndrome, periarthritis, bursitis, and instability/SLAP tears. Non-carpal tunnel release related wrist arthroscopy was most commonly performed for ligament sprains and diagnostic arthroscopies for pain and articular cartilage disorders. Our data shows substantial age and demographic differences in the utilization of these commonly performed upper extremity ambulatory procedures. While over one million upper extremity procedures of interest were performed, evidence-based clinical indications for these procedures remain poorly defined.
登录
查看更多内容
影响因子：
4.8
作者：
Owens, Brett D.;Harrast, John J.;Wolf, Jennifer Moriatis
通讯作者：
Wolf, Jennifer Moriatis
影响因子：
9.9
作者：
Mondelli, M;Giannini, F;Giacchi, M
通讯作者：
Giacchi, M
影响因子：
5.3
作者：
Kim, Sunny;Bosque, Jose;Marder, Richard
通讯作者：
Marder, Richard
DOI：
10.1016/j.arthro.2007.10.006
发表时间：
2008-03-01
影响因子：
4.7
作者：
Chloros, George D.;Wiesler, Ethan R.;Poehling, Gary G.
通讯作者：
Poehling, Gary G.
影响因子：
120.7
作者：
Atroshi, I;Gummesson, C;Rosén, I
通讯作者：
Rosén, I