Marrie Ruth Ann, Yu Bo Nancy, Leung Stella, Elliott Lawrence, Warren Sharon, Wolfson Christina, Tremlett Helen, Blanchard James, Fisk John D
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Mult Scler Relat Disord. 2012 Oct;1(4):162-7. doi: 10.1016/j.msard.2012.06.001. Epub 2012 Jul 6.
Fibromyalgia adversely affects quality of life, yet little is known of the epidemiology of this condition in MS. We aimed to validate and apply administrative case definitions for fibromyalgia in MS.
Using administrative health data we identified persons with MS and an age-, sex- and geographically-matched general population (GP) cohort. Case definitions for fibromyalgia were developed using ICD-9/10 codes, validated against medical records, and applied to evaluate the incidence and prevalence of fibromyalgia.
The case definition for fibromyalgia with ≥5 hospital or physician claims in 3 years had a sensitivity of 60%, specificity of 98%, and agreed moderately with medical records (κ=0.48). In 2005, the age-standardized prevalence of fibromyalgia was 6.82% (95% CI: 5.91-7.72) in the MS population and 3.04% (95% CI: 2.77-3.32) in the GP. After adjustment for age, sex and year, the incidence of fibromyalgia was 44% higher in the MS than the GP (IRR 1.44; 95% CI: 1.01-2.07). The incidence of fibromyalgia increased slightly over time in both populations.
The incidence and prevalence of fibromyalgia are higher in the MS population than the general population. Fibromyalgia should be considered in the management of pain in persons with MS.
纤维肌痛对生活质量有不利影响，但对于多发性硬化症（MS）中这种病症的流行病学了解甚少。我们旨在验证并应用MS中纤维肌痛的行政病例定义。
利用行政健康数据，我们确定了患有MS的人群以及年龄、性别和地理位置匹配的普通人群（GP）队列。使用国际疾病分类第九版/第十版（ICD - 9/10）编码制定纤维肌痛的病例定义，根据病历进行验证，并应用于评估纤维肌痛的发病率和患病率。
三年内有≥5次医院或医生诊疗记录的纤维肌痛病例定义的敏感性为60%，特异性为98%，与病历的一致性中等（κ = 0.48）。2005年，MS人群中纤维肌痛的年龄标准化患病率为6.82%（95%置信区间：5.91 - 7.72），GP人群中为3.04%（95%置信区间：2.77 - 3.32）。在对年龄、性别和年份进行调整后，MS人群中纤维肌痛的发病率比GP人群高44%（发病率比值比1.44；95%置信区间：1.01 - 2.07）。两个群体中纤维肌痛的发病率均随时间略有上升。
MS人群中纤维肌痛的发病率和患病率高于普通人群。在管理MS患者的疼痛时应考虑纤维肌痛。
