Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Pediatric and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark.
Department of Pediatric and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark.
J Pediatr. 2022 Mar;242:32-38.e2. doi: 10.1016/j.jpeds.2021.11.024. Epub 2021 Nov 17.
To identify the prevalence of musculoskeletal diagnoses recorded 6 months before the diagnosis of cancer and to evaluate whether preceding musculoskeletal diagnoses affected survival.
We performed a nationwide registry-based cohort study including all children under 15 years of age diagnosed with cancer in Denmark over a 23-year period (1996-2018). The Danish National Patient Registry was used to identify musculoskeletal diagnoses and associated dates recorded within 6 months preceding the diagnosis of cancer. We compared the characteristics of children with and without a prior musculoskeletal diagnoses using prevalence ratios and 95% CI and diagnostic interval as median with IQR. We compared survival using Kaplan-Meier and Cox proportional hazards regression analysis adjusting for age, sex, and presence of metastasis at diagnosis.
Of 3895 children with all types of cancer, 264 (7%) had a total of 451 hospital visits with musculoskeletal diagnosis within 6 months preceding the diagnosis of cancer; however, survival was not affected. The overall median diagnostic interval from first musculoskeletal diagnosis (within 6 months before cancer diagnosis) to cancer diagnosis was 15 days (IQR, 7-47 days). A diagnosis of juvenile idiopathic arthritis, unspecified arthritis, and arthropathy each accounted for 5% of the contacts, primarily in children with acute lymphoblastic leukemia, bone sarcomas, or neuroblastomas.
A preliminary musculoskeletal diagnosis occurred in 7% of children with cancer, but did not affect the overall survival.
确定癌症诊断前 6 个月记录的肌肉骨骼诊断的患病率，并评估先前的肌肉骨骼诊断是否影响生存。
我们进行了一项全国范围内基于登记的队列研究，纳入了丹麦在 23 年期间（1996-2018 年）诊断为癌症的所有 15 岁以下儿童。丹麦国家患者登记处用于识别在癌症诊断前 6 个月内记录的肌肉骨骼诊断和相关日期。我们使用患病率比和 95%置信区间以及中位数和 IQR 比较了有和没有先前肌肉骨骼诊断的儿童的特征。我们使用 Kaplan-Meier 和 Cox 比例风险回归分析调整年龄、性别和诊断时是否存在转移来比较生存情况。
在 3895 名患有各种癌症的儿童中，264 名（7%）在癌症诊断前 6 个月内总共因肌肉骨骼诊断接受了 451 次住院治疗；然而，生存并未受到影响。从首次肌肉骨骼诊断（癌症诊断前 6 个月内）到癌症诊断的总体中位诊断间隔为 15 天（IQR，7-47 天）。幼年特发性关节炎、未特指关节炎和关节病的诊断各占就诊次数的 5%，主要发生在急性淋巴细胞白血病、骨肉瘤或神经母细胞瘤患儿中。
癌症患儿中有 7%出现初步肌肉骨骼诊断，但不影响总体生存。
