Miah Latif, Strafford Huw, Fonferko-Shadrach Beata, Hollinghurst Joe, Sawhney Inder M S, Hadjikoutis Savvas, Rees Mark I, Powell Rob, Lacey Arron, Pickrell William O
From Swansea University Medical School (L.M., H.S., B.F.-S., J.H., I.M.S.S., M.I.R., R.P., A.L., W.O.P.), Swansea University; Neurology Department (I.M.S.S., S.H., R.P., W.O.P.), Morriston Hospital, Swansea Bay University Health Board; and Faculty of Medicine and Health (M.I.R.), University of Sydney, Australia.
Neurology. 2021 Feb 22;96(8):e1251-e1261. doi: 10.1212/WNL.0000000000011463.
To characterize trends in incidence, prevalence, and health care outcomes in the idiopathic intracranial hypertension (IIH) population in Wales using routinely collected health care data.
We used and validated primary and secondary care IIH diagnosis codes within the Secure Anonymised Information Linkage databank to ascertain IIH cases and controls in a retrospective cohort study between 2003 and 2017. We recorded body mass index (BMI), deprivation quintile, CSF diversion surgery, and unscheduled hospital admissions in case and control cohorts.
We analyzed 35 million patient-years of data. There were 1,765 cases of IIH in 2017 (85% female). The prevalence and incidence of IIH in 2017 was 76/100,000 and 7.8/100,000/y, a significant increase from 2003 (corresponding figures = 12/100,000 and 2.3/100,000/y) ( < 0.001). IIH prevalence is associated with increasing BMI and increasing deprivation. The odds ratio for developing IIH in the least deprived quintile compared to the most deprived quintile, adjusted for sex and BMI, was 0.65 (95% confidence interval 0.55 to 0.76). Nine percent of IIH cases had CSF shunts with less than 0.2% having bariatric surgery. Unscheduled hospital admissions were higher in the IIH cohort compared to controls (rate ratio 5.28, < 0.001) and in individuals with IIH and CSF shunts compared to those without shunts (rate ratio 2.02, < 0.01).
IIH incidence and prevalence is increasing considerably, corresponding to population increases in BMI, and is associated with increased deprivation. This has important implications for health care professionals and policy makers given the comorbidities, complications, and increased health care utilization associated with IIH.
利用常规收集的医疗数据，描述威尔士特发性颅内高压（IIH）人群的发病率、患病率及医疗结局趋势。
在安全匿名信息链接数据库中使用并验证初级和二级医疗IIH诊断代码，以确定2003年至2017年回顾性队列研究中的IIH病例和对照。我们记录了病例组和对照组的体重指数（BMI）、贫困五分位数、脑脊液分流手术和非计划住院情况。
我们分析了3500万患者年的数据。2017年有1765例IIH病例（85%为女性）。2017年IIH的患病率和发病率分别为76/10万和7.8/10万/年，较2003年有显著增加（相应数字分别为12/10万和2.3/10万/年）（<0.001）。IIH患病率与BMI增加和贫困程度增加相关。在调整性别和BMI后，最贫困五分位数人群与最不贫困五分位数人群相比，患IIH的优势比为0.65（95%置信区间0.55至0.76）。9%的IIH病例进行了脑脊液分流术，不到0.2%的病例进行了减肥手术。与对照组相比，IIH队列中的非计划住院率更高（率比5.28；<0.001），与未进行分流术的IIH患者相比，进行脑脊液分流术的IIH患者的非计划住院率更高（率比2.02；<0.01）。
IIH的发病率和患病率显著增加，与人群BMI增加相符，且与贫困程度增加相关。鉴于IIH相关的合并症、并发症及医疗利用率增加，这对医疗专业人员和政策制定者具有重要意义。
