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评估高活性视神经脊髓炎患者的合并症和医疗资源利用情况。

Evaluation of comorbidities and health care resource use among patients with highly active neuromyelitis optica.

机构信息

RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, United States.

Alexion Pharmaceuticals, 100 College Street, New Haven, CT, United States.

出版信息

J Neurol Sci. 2018 Jan 15;384:96-103. doi: 10.1016/j.jns.2017.11.022. Epub 2017 Nov 20.

Abstract

BACKGROUND

Neuromyelitis optica (NMO) is characterized by unpredictable attacks on the optic nerves and spinal cord, causing accumulations of neurological disability that may lead to blindness and paralysis. We examined comorbidities and health care use among patients with highly active NMO, defined as at least two relapses within 12months of the patient's first NMO encounter in the database.

METHODS

This retrospective study of a US administrative claims database compared patients with highly active NMO to matched individuals without NMO. All outcomes, including Charlson Comorbidity Index (CCI) score, hospitalizations, and emergency department visits, were measured over the 12-month period following the patient's first NMO encounter in the database.

RESULTS

A total of 1349 patients with NMO were identified. Of these, 134 had highly active NMO (80% female, mean age 45.6years) and were matched to 670 non-NMO controls. Patients with highly active NMO had significantly greater comorbidity burden than non-NMO controls (mean CCI score: 4.1 versus 0.6; P<0.0001) and greater proportions of hospitalization (53.7% versus 4.0%; P<0.0001) and emergency department visits (60.5% versus 9.7%; P<0.0001).

CONCLUSIONS

High occurrence of several acute and chronic conditions and extensive health care use highlight the significant medical burden among patients with highly active NMO.

摘要

背景

视神经脊髓炎(NMO)的特征是视神经和脊髓的反复发作,导致神经功能障碍的积累,可能导致失明和瘫痪。我们研究了高度活跃性 NMO 患者的合并症和医疗保健使用情况,定义为在数据库中患者首次出现 NMO 后 12 个月内至少有两次复发。

方法

这项对美国行政索赔数据库的回顾性研究将高度活跃性 NMO 患者与没有 NMO 的匹配个体进行了比较。所有结果,包括 Charlson 合并症指数(CCI)评分、住院和急诊就诊,均在患者首次出现数据库中的 NMO 后 12 个月内进行了测量。

结果

共确定了 1349 名 NMO 患者。其中,134 名患有高度活跃性 NMO(80%为女性,平均年龄 45.6 岁),并与 670 名非 NMO 对照组相匹配。与非 NMO 对照组相比,高度活跃性 NMO 患者的合并症负担明显更重(平均 CCI 评分:4.1 对 0.6;P<0.0001),住院(53.7%对 4.0%;P<0.0001)和急诊就诊(60.5%对 9.7%;P<0.0001)的比例更高。

结论

多种急性和慢性疾病的高发和广泛的医疗保健使用突显了高度活跃性 NMO 患者的重大医疗负担。

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