a Humana Inc , Louisville , KY , USA and.
b Division of Toxicology and Human Health Sciences , Agency for Toxic Substances and Disease Registry/Centers for Disease Control and Prevention , Atlanta , GA , USA.
Amyotroph Lateral Scler Frontotemporal Degener. 2019 May;20(3-4):251-259. doi: 10.1080/21678421.2019.1582674. Epub 2019 Mar 20.
: To estimate amyotrophic lateral sclerosis (ALS) prevalence, 5-year survival, and explore factors associated with survival in a Medicare population. : A validated administrative claims algorithm was used to classify individual's ages 18-89 years at index date (first claim with a diagnosis of motor neuron disease or ALS between 1 January 2007 and 31 December 2011) with Medicare Advantage prescription drug coverage into mutually exclusive categories: ALS, no ALS, and possible ALS. Crude prevalence and cumulative survival from index date to the date of death, disenrollment or end of the study were calculated. Cox-proportional hazards were used to estimate and explore factors associated with survival. : Of 2631 eligible individuals, the algorithm identified 1271 (48 %), 1157 (44 %), 203 (8 %) as ALS, no ALS and possible ALS, respectively. The 5-year period prevalence and the 2011 point prevalence of ALS were 20.5 and 11.8 per 100,000, respectively. Evidence of death was documented in 81%, 35%, and 1.6% of the ALS, no ALS or possible ALS groups, respectively. Unadjusted median survival time was 388, 542 and 1473 days for the ALS, no ALS and possible ALS groups, respectively. Seeing a psychiatrist or neurologist at the index visit, having respiratory or genitourinary comorbidities, and the number of pre-index acute inpatient admissions were associated with shorter survival. : Surveillance data from a Medicare population demonstrated a higher prevalence of ALS. Results highlight the need for effective ALS treatment options and resources for patients with ALS who will likely face limited therapeutic choices and care options at the end of life.
为了估计肌萎缩侧索硬化症（ALS）的患病率、5 年生存率，并探讨医疗保险人群中与生存相关的因素。：使用经过验证的行政索赔算法，将索引日期（2007 年 1 月 1 日至 2011 年 12 月 31 日期间首次诊断为运动神经元疾病或 ALS 的个人年龄在 18-89 岁）的个体分为相互排斥的类别：ALS、无 ALS 和可能的 ALS，有医疗保险优势处方药覆盖范围。从索引日期到死亡、退出或研究结束的日期，计算了粗患病率和累积生存率。使用 Cox 比例风险来估计和探讨与生存相关的因素。：在 2631 名符合条件的个体中，算法分别识别出 1271 名（48%）、1157 名（44%）和 203 名（8%）为 ALS、无 ALS 和可能的 ALS。ALS 的 5 年期间患病率和 2011 年时点患病率分别为 20.5 和 11.8/10 万。分别有 81%、35%和 1.6%的 ALS、无 ALS 和可能的 ALS 组记录了死亡证据。未调整的中位生存时间分别为 ALS、无 ALS 和可能的 ALS 组的 388、542 和 1473 天。索引就诊时看精神科医生或神经科医生、有呼吸系统或泌尿生殖系统合并症以及索引前急性住院入院次数与较短的生存时间相关。：医疗保险人群的监测数据显示 ALS 的患病率较高。结果强调了需要为 ALS 患者提供有效的 ALS 治疗选择和资源，因为这些患者在生命结束时可能面临有限的治疗选择和护理选择。
