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利用医疗保险数据,按类型、年龄、性别和肥胖程度对脊柱退化诊断的流行情况进行分析。

Prevalence of spine degeneration diagnosis by type, age, gender, and obesity using Medicare data.

机构信息

Exponent, Inc., 3350 Peachtree Road NE, Suite 1125, Atlanta, GA, 30326, USA.

出版信息

Sci Rep. 2021 Mar 8;11(1):5389. doi: 10.1038/s41598-021-84724-6.

Abstract

Identifying the prevalence of degenerative spinal pathologies and relevant demographic risk factors is important for understanding spine injury risk, prevention, treatment, and outcome, and for distinguishing acute injuries from degenerative pathologies. Prevalence data in the literature are often based on small-scale studies focused on a single type of pathology. This study evaluates the prevalence of diagnosis of selected degenerative spinal pathology diagnoses using Medicare insurance claim data in the context of published smaller-scale studies. In addition, the data are used to evaluate whether the prevalence is affected by age, sex, diagnosed obesity, and the use of medical imaging. The Medicare Claims 5% Limited Data Set was queried to identify diagnoses of degenerative spinal pathologies. Unique patient diagnoses per year were further evaluated as a function of age, gender, and obesity diagnosis. Participants were also stratified by coding for radiological imaging accompanying each diagnosis. The overall prevalence of diagnosed spinal degenerative disease was 27.3% and increased with age. The prevalence of diagnosed disc disease was 2.7 times greater in those with radiology. The results demonstrate that degenerative findings in the spine are common, and, since asymptomatic individuals may not receive a diagnosis of degenerative conditions, this analysis likely underestimates the general prevalence of these conditions.

摘要

确定退行性脊柱病变的流行率和相关的人口统计学风险因素对于了解脊柱损伤风险、预防、治疗和结果非常重要,并且对于区分急性损伤和退行性病变也很重要。文献中的流行率数据通常基于针对单一类型病变的小规模研究。本研究使用医疗保险索赔数据,在已发表的小规模研究的背景下,评估选定退行性脊柱病变诊断的流行率。此外,还利用这些数据评估流行率是否受年龄、性别、诊断出的肥胖症以及医疗成像的影响。查询了 Medicare 索赔 5%有限数据集,以确定退行性脊柱病变的诊断。进一步根据每年每位患者的独特诊断,评估年龄、性别和肥胖症诊断的影响。还根据每个诊断伴随的放射影像学编码对参与者进行分层。诊断为脊柱退行性疾病的总体流行率为 27.3%,且随年龄增长而增加。有放射影像学证据的患者椎间盘疾病的诊断率是没有放射影像学证据的患者的 2.7 倍。结果表明,脊柱退行性病变很常见,由于无症状个体可能不会被诊断为退行性疾病,因此这种分析可能低估了这些疾病的普遍流行率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f94/7940625/9efb0af9bdd0/41598_2021_84724_Fig1_HTML.jpg

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