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在英国,普通医疗记录中记录的胃轻瘫的流行病学和结果。

Epidemiology and outcomes of gastroparesis, as documented in general practice records, in the United Kingdom.

机构信息

Global Evidence and Outcomes, Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, USA

Safety and Observational Statistics, Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, USA.

出版信息

Gut. 2021 Apr;70(4):644-653. doi: 10.1136/gutjnl-2020-321277. Epub 2020 Jun 3.

Abstract

OBJECTIVE

To generate real-world evidence for the epidemiology of gastroparesis in the UK, we evaluated the prevalence, incidence, patient characteristics and outcomes of gastroparesis in the Clinical Practice Research Datalink (CPRD) database.

DESIGN

This was a retrospective, cross-sectional study. Prevalence and incidence of gastroparesis were evaluated in the CPRD database, with linkage to Hospital Episodes Statistics Admitted Patient Care and Office for National Statistics mortality data. Prevalence and incidence were age and sex standardised to mid-2017 UK population estimates. Descriptive analyses of demographics, aetiologies, pharmacological therapies and mortality were conducted.

RESULTS

Standardised prevalence of gastroparesis, as documented in general practice records, was 13.8 (95% CI 12.6 to 15.1) per 100 000 persons in 2016, and standardised incidence of gastroparesis rose from 1.5 (95% CI 1.1 to 1.8) per 100 000 person-years in 2004 to 1.9 (95% CI 1.4 to 2.3) per 100 000 person-years in 2016. The most common disease aetiologies were idiopathic (39.4%) and diabetic gastroparesis (37.5%), with a similar distribution of type 1 and type 2 diabetes among the 90% who had type of diabetes documented. Patients with diabetic gastroparesis had a significantly higher risk of mortality than those with idiopathic gastroparesis after diagnosis (adjusted HR 1.9, 95% CI 1.2 to 3.0). Of those with gastroparesis, 31.6% were not offered any recognised pharmacological therapy after diagnosis.

CONCLUSION

This is, to our knowledge, the first population-based study providing data on epidemiology and outcomes of gastroparesis in Europe. Further research is required to fully understand the factors influencing outcomes and survival of patients with gastroparesis.

摘要

目的

为了生成英国胃轻瘫流行病学的真实世界证据,我们评估了临床实践研究数据链(CPRD)数据库中胃轻瘫的患病率、发病率、患者特征和结局。

设计

这是一项回顾性、横断面研究。CPRD 数据库中评估了胃轻瘫的患病率和发病率,并与医院发病统计数据和国家统计局死亡率数据进行了关联。患病率和发病率按年龄和性别标准化为 2017 年中期英国人口估计值。对人口统计学、病因、药物治疗和死亡率进行了描述性分析。

结果

在 2016 年,普通诊所记录中记录的胃轻瘫标准化患病率为每 10 万人 13.8(95%CI 12.6 至 15.1),胃轻瘫的标准化发病率从 2004 年的每 10 万人年 1.5(95%CI 1.1 至 1.8)上升至 2016 年的每 10 万人年 1.9(95%CI 1.4 至 2.3)。最常见的疾病病因是特发性(39.4%)和糖尿病性胃轻瘫(37.5%),在记录了糖尿病类型的 90%患者中,1 型和 2 型糖尿病的分布相似。与特发性胃轻瘫患者相比,诊断后糖尿病性胃轻瘫患者的死亡风险显著更高(调整后的 HR 1.9,95%CI 1.2 至 3.0)。在患有胃轻瘫的患者中,31.6%的患者在诊断后未接受任何公认的药物治疗。

结论

据我们所知,这是第一项提供欧洲胃轻瘫流行病学和结局数据的基于人群的研究。需要进一步研究以充分了解影响胃轻瘫患者结局和生存的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c2b/7948194/202d82458fd3/gutjnl-2020-321277f01.jpg

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