Rochoy M, Chazard E, Gautier S, Bordet R
University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France; Département de médecine générale, 1 Place de Verdun, 59000 Lille, France.
University Lille, 59000 Lille, France; EA2694, Public Health Department, 59000 Lille, France.
Ann Cardiol Angeiol (Paris). 2019 Jun;68(3):150-154. doi: 10.1016/j.ancard.2018.10.011. Epub 2018 Nov 6.
Vascular dementia (VaD) is the second leading cause of dementia. Diagnostic criteria have evolved from the concept of multiple infarctions to different subtypes: acute onset VaD, subcortical VaD, mixed cortical and subcortical VaD. Our aim was to analyze the evolution in the coding of these different subtypes of VaD in the French nationwide exhaustive hospital discharge database (PMSI) between 2007 and 2017.
We included all principal diagnoses of VaD in the PMSI hospital stays from 2007 to 2017.
Between 2007 and 2017, we show a relative decrease in the number of hospital stays for VaD compared to all hospital stays (0.0437% to 0.0404%). The 11,654 hospital stays for VaD in 2017 represent 13.5% of mental organic disorders. Subtype analysis shows a decrease in hospital stays for multiple infarctions between 2007 and 2017 (-50%), an increase for subcortical or mixed VaD (+20%), acute onset VaD (+184%) and an increase in "other VaD" (+85%).
These data suggest a slight decrease in hospital stays for VaD, possibly related to better control of cardiovascular risk factors. They also suggest that the coding should be consistent with the evolution of diagnostic criteria.
血管性痴呆(VaD)是痴呆的第二大主要病因。诊断标准已从多发性梗死的概念演变为不同亚型:急性起病型VaD、皮质下VaD、皮质和皮质下混合性VaD。我们的目的是分析2007年至2017年期间法国全国详尽的医院出院数据库(PMSI)中这些不同亚型VaD编码的演变情况。
我们纳入了2007年至2017年PMSI医院住院期间所有VaD的主要诊断。
2007年至2017年期间,与所有住院病例相比,我们发现VaD的住院病例数相对减少(从0.0437%降至0.0404%)。2017年VaD的11,654例住院病例占精神器质性障碍的13.5%。亚型分析显示,2007年至2017年期间多发性梗死的住院病例数减少(-50%),皮质下或混合性VaD增加(+20%),急性起病型VaD增加(+184%),“其他VaD”增加(+85%)。
这些数据表明VaD的住院病例数略有减少,可能与心血管危险因素得到更好控制有关。它们还表明编码应与诊断标准的演变保持一致。