McMillan Kathleen
gRadiant Research, LLC, Concord, Mass., USA.
Skin Appendage Disord. 2016 Feb;1(3):117-22. doi: 10.1159/000439438. Epub 2015 Sep 18.
Hidradenitis suppurativa (HS) is rarely diagnosed in the United States. Delayed diagnosis is a significant problem in the management of HS. In the past decade, there has been an increase in HS research. To determine whether those efforts have led to an increase in diagnoses, an analysis of visits to physicians in the United States from 1979 to 2012 was performed, using National Center for Health Statistics (NCHS) databases. Patient visits to private physician offices, hospital outpatient departments, and emergency rooms were analyzed. An increase in visit rates at outpatient departments from 2003-2007 [6.3/100,000, 95% confidence interval (CI) 2.9-9.8] to 2008-2010 (30.4/100,000, 95% CI 13.9-46.9; p = 0.017) was found. Converting the data to estimated numbers of patients, a 7-fold increase in patients from 2002-2007 (2.5/100,000, 95% CI 1.4-3.6) to 2008-2010 (16.9/100,000, 95% CI 7.8-26.1; p = 0.003) was found. No significant increase in patient or patient visit rates were found when analyzing visits in the physician office setting or combined office and hospital settings. Localization of increased diagnosis to outpatient departments may reflect the recent increase in clinical research. NCHS data can be useful in monitoring rates of HS diagnosis as an outcome of increased awareness of the disease.
化脓性汗腺炎(HS)在美国很少被诊断出来。延迟诊断是HS治疗中的一个重大问题。在过去十年中,HS研究有所增加。为了确定这些努力是否导致诊断增加,利用国家卫生统计中心(NCHS)数据库对1979年至2012年美国医生的就诊情况进行了分析。分析了患者到私人医生办公室、医院门诊部和急诊室的就诊情况。发现门诊部的就诊率从2003 - 2007年的[6.3/10万,95%置信区间(CI)2.9 - 9.8]增加到2008 - 2010年(30.4/10万,95% CI 13.9 - 46.9;p = 0.017)。将数据转换为估计患者数量后,发现从2002 - 2007年(2.5/10万,95% CI 1.4 - 3.6)到2008 - 2010年(16.9/10万,95% CI 7.8 - 26.1;p = 0.003)患者数量增加了7倍。在分析医生办公室环境或综合办公室与医院环境中的就诊情况时,未发现患者或患者就诊率有显著增加。诊断增加集中在门诊部可能反映了近期临床研究的增加。NCHS数据在监测HS诊断率作为疾病认知度提高的结果方面可能有用。