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丹麦 1 型神经纤维瘤病的多系统负担:终生住院率的登记和基于人群的研究。

Multisystem burden of neurofibromatosis 1 in Denmark: registry- and population-based rates of hospitalizations over the life span.

机构信息

Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.

Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark.

出版信息

Genet Med. 2020 Jun;22(6):1069-1078. doi: 10.1038/s41436-020-0769-6. Epub 2020 Feb 28.

Abstract

PURPOSE

The aim was to assess lifetime risk for hospitalization in individuals with neurofibromatosis 1 (NF1).

METHODS

The 2467 individuals discharged with a diagnosis indicating NF1 or followed in a clinical center for NF1 were matched to 20,132 general population comparisons. Based on diagnoses in 12 main diagnostic groups and 146 subcategories, we calculated rate ratios (RRs), absolute excess risks (AERs), and hazard ratios for hospitalizations.

RESULTS

The RR for any first hospitalization among individuals with NF1 was 2.3 (95% confidence interval 2.2-2.5). A high AER was seen for all 12 main diagnostic groups, dominated by disorders of the nervous system (14.5% of all AERs), benign (13.6%) and malignant neoplasms (13.4%), and disorders of the digestive (10.5%) and respiratory systems (10.3%). Neoplasms, nerve and peripheral ganglia disease, pneumonia, epilepsy, bone and joint disorders, and intestinal infections were major contributors to the excess disease burden caused by NF1. Individuals with NF1 had more hospitalizations and spent more days in hospital than the comparisons. The increased risk for any hospitalization was observed for both children and adults, with or without an associated cancer.

CONCLUSION

NF1 causes an overall greater likelihood of hospitalization, with frequent and longer hospitalizations involving all organ systems throughout life.

摘要

目的

评估神经纤维瘤病 1 型(NF1)患者的住院终生风险。

方法

对 2467 名诊断为 NF1 或在 NF1 临床中心接受随访的患者与 20132 名普通人群对照进行匹配。根据 12 个主要诊断组和 146 个亚类别的诊断,我们计算了住院率比(RR)、绝对超额风险(AER)和住院风险比。

结果

NF1 患者首次住院的 RR 为 2.3(95%置信区间 2.2-2.5)。所有 12 个主要诊断组的 AER 均较高,其中以神经系统疾病(占所有 AER 的 14.5%)、良性(13.6%)和恶性肿瘤(13.4%)、消化系统(10.5%)和呼吸系统疾病(10.3%)为主。肿瘤、神经和周围神经节疾病、肺炎、癫痫、骨骼和关节疾病以及肠道感染是 NF1 导致疾病负担增加的主要原因。NF1 患者的住院次数和住院天数均多于对照组。无论是否伴有癌症,儿童和成人的任何住院风险均增加。

结论

NF1 导致整体住院可能性增加,涉及所有器官系统,且住院频繁且时间长。

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