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轮状病毒胃肠炎与肠套叠的关联性:来自美国索赔数据库回顾性研究的提示性证据。

Association between rotavirus gastroenteritis and intussusception: suggested evidence from a retrospective study in claims databases in the United States.

机构信息

GSK Vaccines , Wavre, Belgium.

出版信息

Hum Vaccin Immunother. 2021 Jan 2;17(1):269-277. doi: 10.1080/21645515.2020.1770514. Epub 2020 Jul 1.

Abstract

The etiology of intussusception (IS), a serious gastrointestinal obstruction, remains unclear. Limited evidence suggests a role for viral infection. We investigated the risk of IS after rotavirus gastroenteritis (RV GE) in the first year of life. In this retrospective, self-controlled case series (SCCS), we assessed the risk of IS after RV GE using data from United States administrative claims databases. Incidence rate ratios (IRR) of IS were calculated for the 7- and 21-day risk periods after RV GE (main analysis) or after fracture (sensitivity analysis). A total of 290,912,068 subjects were screened; 42 presented claims for RV GE and IS, and 66 for fracture and IS. The IRRs of IS after RV GE were 79.6 (95% confidence interval, CI: 38.6-164.4) and 25.5 (95% CI: 13.2-49.2) in the 7- and 21-day risk periods. The sensitivity analysis showed an association between IS and fracture for both periods, suggesting potential confounding. Post-hoc analyses did not confirm the association between fracture and IS but suggested a potential association between RV GE and IS. A temporal association between RV GE and IS was detected using claims databases. Due to some limitations of the data sources, this association should be further investigated.

摘要

肠套叠(IS)是一种严重的胃肠道梗阻,其病因尚不清楚。有限的证据表明病毒感染可能起作用。我们研究了轮状病毒胃肠炎(RVGE)后第一年发生 IS 的风险。在这项回顾性自身对照病例系列研究(SCCS)中,我们使用来自美国行政索赔数据库的数据评估了 RVGE 后发生 IS 的风险。计算了 RVGE 后 7 天和 21 天风险期(主要分析)或骨折后(敏感性分析)IS 的发病率比(IRR)。共筛选了 290,912,068 名受试者;42 名受试者有 RVGE 和 IS 的索赔,66 名受试者有骨折和 IS 的索赔。RVGE 后 7 天和 21 天风险期内 IS 的 IRR 分别为 79.6(95%置信区间,CI:38.6-164.4)和 25.5(95% CI:13.2-49.2)。敏感性分析显示,两个时期 IS 与骨折之间均存在关联,表明存在潜在的混杂因素。事后分析并未证实骨折与 IS 之间的关联,但提示 RVGE 与 IS 之间存在潜在关联。通过索赔数据库检测到 RVGE 和 IS 之间存在时间关联。由于数据源的一些局限性,应进一步调查这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58c3/7872044/e19115bb578d/KHVI_A_1770514_F0001_B.jpg

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