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加利福尼亚州、佛罗里达州、纽约州和威斯康星州医院出院记录中恶性高热诊断的流行情况。

Prevalence of malignant hyperthermia diagnosis in hospital discharge records in California, Florida, New York, and Wisconsin.

机构信息

Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168(th) St, R1508, New York, NY 10032, USA.

Department of Medical Education and Clinical Research, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ 07039, USA.

出版信息

J Clin Anesth. 2017 Jun;39:10-14. doi: 10.1016/j.jclinane.2017.03.016. Epub 2017 Mar 14.

Abstract

STUDY OBJECTIVE

Malignant hyperthermia (MH) is a rare yet potentially fatal pharmacogenetic disorder triggered by exposure to inhalational anesthetics and the depolarizing neuromuscular blocking agent succinylcholine. Epidemiologic data on the geographic variation in MH prevalence is scant. The objective of this study is to examine the prevalence of recorded MH diagnosis in patients discharged from hospitals in four states in the United States.

DESIGN

Observational study.

SETTING

Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for California (2011), Florida (2011), New York (2012) and Wisconsin (2012).

PATIENTS

A total of 164 hospital discharges that had a recorded diagnosis of MH using the International Classification of Disease, 9th Revision, Clinical Modification code 995.86.

METHODS

MH prevalence was assessed by patient demographic and clinical characteristics.

MAIN RESULTS

The prevalence of MH per 100,000 hospital discharges ranged from 1.23 (95% Confidence Interval [CI], 0.80-1.66) in New York to 1.91 (95% CI, 1.48-2.34) in California, and the prevalence of MH per 100,000 surgical discharges ranged from 1.47 (95% CI, 0.93-2.02) in New York to 2.86 (95% CI, 2.00-3.71) in Florida. The prevalence of MH in male patients was more than twice the prevalence in female patients. Of the 164 patients with MH diagnosis, 11% were dead on discharge.

CONCLUSIONS

There exists a modest variation in the prevalence of recorded MH diagnosis in hospital discharges in California, Florida, New York and Wisconsin. Epidemiologic patterns of MH diagnosis in hospital discharges appear to be similar across the four states. Further research is needed to better understand the geographic variation and contributing factors of MH in different populations.

摘要

研究目的

恶性高热(MH)是一种罕见但潜在致命的遗传药理学疾病,由吸入麻醉剂和去极化神经肌肉阻滞剂琥珀酰胆碱暴露引起。关于 MH 患病率的地理变异的流行病学数据很少。本研究的目的是检查美国四个州出院患者记录的 MH 诊断患病率。

设计

观察性研究。

设置

医疗保健成本和利用项目(HCUP)州住院患者数据库(SID),用于加利福尼亚州(2011 年)、佛罗里达州(2011 年)、纽约州(2012 年)和威斯康星州(2012 年)。

患者

共 164 例出院患者,其 MH 记录诊断使用国际疾病分类,第 9 版临床修订版代码 995.86。

方法

通过患者的人口统计学和临床特征评估 MH 患病率。

主要结果

每 100,000 例出院患者 MH 患病率从纽约的 1.23(95%置信区间[CI],0.80-1.66)到加利福尼亚的 1.91(95% CI,1.48-2.34),每 100,000 例手术出院患者 MH 患病率从纽约的 1.47(95% CI,0.93-2.02)到佛罗里达州的 2.86(95% CI,2.00-3.71)。男性患者的 MH 患病率是女性患者的两倍多。在 164 例 MH 诊断患者中,11%的患者出院时死亡。

结论

在加利福尼亚州、佛罗里达州、纽约州和威斯康星州的出院患者中,记录的 MH 诊断患病率存在适度差异。四个州出院患者的 MH 诊断流行病学模式似乎相似。需要进一步研究以更好地了解不同人群中 MH 的地理变异和促成因素。

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