Ghaffari-Rafi Arash, Mehdizadeh Rana, Ghaffari-Rafi Shadeh, Leon-Rojas Jose
University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, HI, USA.
University of Queensland, Faculty of Medicine, Brisbane, Australia.
J Neurol Sci. 2020 Nov 15;418:117152. doi: 10.1016/j.jns.2020.117152. Epub 2020 Sep 23.
Epidemiology provides an avenue for identifying disease pathogenesis, hence determining national incidence, along with socioeconomic and demographic variables involved in iNPH, can provide direction in elucidating the etiology and addressing healthcare inequalities.
To investigate incidence (per 100,000) of iNPH diagnoses applied to the inpatient population, with respect to sex, age, income, residence, and race/ethnicity, we queried the largest American administrative dataset (2008-2016), the National (Nationwide) Inpatient Sample (NIS), which surveys 20% of United States (US) discharges.
Annual national inpatient incidence (with 25th and 75th quartiles) for iNPH diagnoses was 2.86 (2.72, 2.93). Males had an inpatient incidence of 3.27 (3.11, 3.39), higher (p = 0.008) than female at 2.45 (2.41, 2.47). Amongst age groups inpatient incidence varied (p = 0.000004) and was largest amongst the 85+ group at 18.81 (16.40, 19.95). Individuals with middle/high income had an inpatient incidence of 2.96 (2.77, 3.06), higher (p = 0.008) than the 2.37 (2.24, 2.53) of low-income patients. Depending on whether patients lived in urban, suburban, or rural communities, inpatient incidence diverged (p = 0.01) as follows, respectively: 2.65; 2.66; 3.036. Amongst race/ethnicity (p = 0.000003), inpatient incidence for Whites, Blacks, Hispanics, Asian/Pacific Islanders, and Native Americans were as follows, respectively: 3.88 (3.69, 3.93), 1.065 (1.015, 1.14); 0.82 (0.76, 0.85); 0.43 (0.33, 0.52); 0.027 (0.026, 0.12).
In the US, inpatient incidence for iNPH diagnoses exhibited disparities between socioeconomic and demographic strata, emphasizing a healthcare inequality. Disproportionately, diagnoses were applied most to patients who were White, male, 65 and older, middle/high income, and living in rural communities.
流行病学为确定疾病发病机制提供了途径，因此，确定iNPH的全国发病率以及与之相关的社会经济和人口变量，可为阐明病因和解决医疗保健不平等问题提供指导。
为了调查应用于住院患者群体的iNPH诊断的发病率（每10万人），我们查询了最大的美国行政数据集（2008 - 2016年），即国家（全国）住院患者样本（NIS），该数据集对美国20%的出院病例进行调查，涉及性别、年龄、收入、居住地和种族/民族。
iNPH诊断的年度全国住院发病率（第25和第75四分位数）为2.86（2.72，2.93）。男性的住院发病率为3.27（3.11，3.39），高于女性的2.45（2.41，2.47）（p = 0.008）。在各年龄组中，住院发病率有所不同（p = 0.000004），85岁及以上年龄组的发病率最高，为18.81（16.40，19.95）。中/高收入个体的住院发病率为2.96（2.77，3.06），高于低收入患者的2.37（2.24，2.53）（p = 0.008）。根据患者居住在城市、郊区还是农村社区，住院发病率有所差异（p = 0.01），分别如下：2.65；2.66；3.036。在种族/民族方面（p = 0.000003），白人、黑人、西班牙裔、亚太岛民和美国原住民的住院发病率分别如下：3.88（3.69，3.93）、1.065（1.015，1.14）、0.82（0.76，0.85）、0.43（0.33，0.52）、0.027（0.026，0.12）。
在美国，iNPH诊断的住院发病率在社会经济和人口阶层之间存在差异，这突出了医疗保健的不平等。不成比例的是，诊断主要适用于白人、男性、65岁及以上、中/高收入且居住在农村社区的患者。
