Epidemiology, OptumInsight, Waltham, MA 02451, USA.
Pediatr Infect Dis J. 2012 Mar;31(3):287-91. doi: 10.1097/INF.0b013e31824213b1.
To estimate the incidence of intussusception among infants treated in inpatient and emergency department settings during the period preceding the US launch of second-generation rotavirus vaccines.
From a large US health insurance claims database, we sampled 100,000 infants aged 1 to 3 months at first diphtheria-tetanus-acellular pertussis vaccination between 2001 and 2005. Potential intussusception cases were identified on the basis of claims and were confirmed by medical record review. Incidence rates (IRs) and 95% confidence intervals (CIs) were estimated based on follow-up from first diphtheria-tetanus-acellular pertussis dose to up to 1 year of age, and within 21, 30, and 60 days after each dose.
The IR of intussusception in the first year of life was 0.33/1000 person-years based on 22 confirmed cases (95% CI: 0.21-0.50/1000 person-years). The age-specific incidence peaked among infants aged 5 months (IR: 0.82/1000 person-years; 95% CI: 0.30-1.78/1000 person-years). During the 21, 30, and 60 days following any dose, the incidence per 1000 person-years was 0.27, 0.24, and 0.33, respectively.
The rates described in this study can serve as a benchmark for comparison with incidences observed after the introduction of the second-generation rotavirus vaccines.
估计在美国推出第二代轮状病毒疫苗之前，在住院和急诊环境中接受治疗的婴儿中肠套叠的发生率。
我们从一个大型的美国健康保险索赔数据库中抽取了 2001 年至 2005 年间首次接受白喉-破伤风-无细胞百日咳疫苗接种的 1 至 3 个月大的 100,000 名婴儿。根据索赔确定了潜在的肠套叠病例，并通过病历审查进行了确认。根据首次白喉-破伤风-无细胞百日咳剂量至 1 岁以及每次剂量后 21、30 和 60 天的随访，估计了发病率（IR）和 95%置信区间（CI）。
根据 22 例确诊病例，在生命的第一年中肠套叠的发病率为 0.33/1000 人年（95%CI：0.21-0.50/1000 人年）。5 月龄婴儿的年龄特异性发病率最高（IR：0.82/1000 人年；95%CI：0.30-1.78/1000 人年）。在任何剂量后的 21、30 和 60 天内，每 1000 人年的发病率分别为 0.27、0.24 和 0.33。
本研究中描述的这些发生率可以作为与第二代轮状病毒疫苗推出后观察到的发生率进行比较的基准。
