Lirhus Sandre Svatun, Høivik Marte Lie, Moum Bjørn, Anisdahl Karoline, Melberg Hans Olav
Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.
Clin Epidemiol. 2021 Apr 23;13:287-294. doi: 10.2147/CLEP.S303797. eCollection 2021.
Countries have different diagnostic procedures and treatment regimens for inflammatory bowel disease (IBD) patients. In addition to differences in population characteristics, completeness of data and health registries, different follow-up time and case definitions can have a large impact on estimates of the incidence and prevalence of IBD.
The aim of this study was to use hospital and prescription data to estimate incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC), using different case definitions.
This study used nationwide data from the Norwegian Patient Registry (2008 to 2017) and the Norwegian Prescription Database (2004 to April 2018). Incidence and prevalence were estimated using different case definitions of an IBD patient, varying the number of IBD-related hospital visits and IBD prescriptions required. The base case definition included patients with at least one IBD hospital visit and two IBD prescriptions or two IBD hospital visits.
From 2010 to 2017, 16,758 incident IBD patients fulfilled our base case definition, with 6045 diagnosed with CD (36.1%) and 10,713 (63.9%) with UC. For CD, 47.2% of the patients were male while 53.8% of UC patients were male. The base case incidence varied between 14.1 and 16.0 per 100,000 person-years for CD and 24.7 and 28.4/100,000 person-years for UC patients in the years 2010-2017. When we required at least two IBD hospital visits, not utilizing the prescription data, the CD incidence was 22.3 per 100,000 person-years in 2010 and 13.9 per 100,000 person-years in 2017. For UC, the incidence was 47.4 and 20.6 per 100,000 person-years in 2010 and 2017. In 2017, the prevalence of CD was 0.27% (95% CI: 0.26-0.27) and 0.50% (95% CI: 0.490-0.502) for UC.
According to our base case definition, the incidence of IBD in Norway was stable from 2010 to 2017. Both the incidence and prevalence of IBD in Norway is among the highest in the world. Moreover, the study also highlights the consequences of different case definitions.
各国对炎症性肠病（IBD）患者有不同的诊断程序和治疗方案。除了人口特征、数据完整性和健康登记存在差异外，不同的随访时间和病例定义对IBD发病率和患病率的估计可能有很大影响。
本研究旨在利用医院和处方数据，采用不同的病例定义来估计克罗恩病（CD）和溃疡性结肠炎（UC）的发病率和患病率。
本研究使用了来自挪威患者登记处（2008年至2017年）和挪威处方数据库（2004年至2018年4月）的全国性数据。通过使用IBD患者的不同病例定义来估计发病率和患病率，改变所需的IBD相关医院就诊次数和IBD处方数量。基本病例定义包括至少有一次IBD医院就诊和两张IBD处方或两次IBD医院就诊的患者。
2010年至2017年，16758例新发IBD患者符合我们的基本病例定义，其中6045例被诊断为CD（36.1%），10713例（63.9%）为UC。对于CD，47.2%的患者为男性，而UC患者中53.8%为男性。2010 - 2017年期间，CD的基本病例发病率在每10万人年14.1至16.0之间，UC患者为每10万人年24.7至28.4。当我们要求至少两次IBD医院就诊，不使用处方数据时，2010年CD发病率为每10万人年22.3，2017年为每10万人年13.9。对于UC，2010年和2017年的发病率分别为每10万人年47.4和20.6。2017年，CD的患病率为0.27%（95%CI：0.26 - 0.27），UC为0.50%（95%CI：0.490 - 0.502）。
根据我们的基本病例定义，2010年至2017年挪威IBD的发病率保持稳定。挪威IBD的发病率和患病率均位居世界前列。此外，该研究还突出了不同病例定义的影响。
