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2018年和2019年美国脑静脉窦血栓形成及合并血小板减少的脑静脉窦血栓形成的流行病学

Epidemiology of cerebral venous sinus thrombosis and cerebral venous sinus thrombosis with thrombocytopenia in the United States, 2018 and 2019.

作者信息

Payne Amanda B, Adamski Alys, Abe Karon, Reyes Nimia L, Richardson Lisa C, Hooper William Craig, Schieve Laura A

机构信息

Division of Blood Disorders National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Atlanta Georgia USA.

Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA.

出版信息

Res Pract Thromb Haemost. 2022 Mar 7;6(2):e12682. doi: 10.1002/rth2.12682. eCollection 2022 Feb.

Abstract

BACKGROUND

Population-based data about cerebral venous sinus thrombosis (CVST) are limited.

OBJECTIVES

To investigate the epidemiology of CVST in the United States.

PATIENTS/METHODS: Three administrative data systems were analyzed: the 2018 Healthcare Cost and Utilization Project National Inpatient Sample (NIS) the 2019 IBM MarketScan Commercial and Medicare Supplemental Claims Database, and the 2019 IBM MarketScan Multi-state Medicaid Database. CVST, thrombocytopenia, and numerous comorbidities were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. Incidence rates of CVST and CVST with thrombocytopenia were estimated (per 100,000 total US population [NIS] and per 100,000 population aged 0 to 64 years covered by relevant contributing health plans [MarketScan samples]). Comorbidity prevalence was estimated among CVST cases versus total inpatients in the NIS sample. Recent pregnancy prevalence was estimated for the Commercial sample.

RESULTS

Incidence rates of CVST in NIS, Commercial, and Medicaid samples were 2.85, 2.45, and 3.16, respectively. Incidence rates of CVST with thrombocytopenia were 0.21, 0.22, and 0.16, respectively. In all samples, CVST incidence increased with age; however, peak incidence was reached at younger ages in females than males. Compared with the general inpatient population, persons with CVST had higher prevalences of hemorrhagic stroke, ischemic stroke, other venous thromboembolism (VTE), central nervous system infection, head or neck infection, prior VTE, thrombophilia, malignancy, head injury, hemorrhagic disorder, and connective tissue disorders. Women aged 18 to 49 years with CVST had a higher pregnancy prevalence than the same-aged general population.

CONCLUSIONS

Our findings provide recent and comprehensive data on the epidemiology of CVST and CVST with thrombocytopenia.

摘要

背景

基于人群的脑静脉窦血栓形成(CVST)数据有限。

目的

调查美国CVST的流行病学情况。

患者/方法:分析了三个管理数据系统:2018年医疗保健成本和利用项目全国住院患者样本(NIS)、2019年IBM MarketScan商业和医疗保险补充索赔数据库以及2019年IBM MarketScan多州医疗补助数据库。使用国际疾病分类第十次修订本临床修订版代码识别CVST、血小板减少症和多种合并症。估计CVST以及伴有血小板减少症的CVST的发病率(每10万美国总人口[NIS]以及每10万年龄在0至64岁且由相关参与健康计划覆盖的人群[MarketScan样本])。在NIS样本中估计CVST病例与全部住院患者的合并症患病率。估计商业样本中近期妊娠的患病率。

结果

NIS样本、商业样本和医疗补助样本中CVST的发病率分别为2.85、2.45和3.16。伴有血小板减少症的CVST发病率分别为0.21、0.22和0.16。在所有样本中,CVST发病率均随年龄增长而升高;然而,女性的发病率峰值出现的年龄比男性更小。与普通住院患者人群相比,CVST患者出血性卒中、缺血性卒中、其他静脉血栓栓塞(VTE)、中枢神经系统感染、头颈部感染、既往VTE、血栓形成倾向、恶性肿瘤、头部损伤、出血性疾病和结缔组织疾病的患病率更高。患有CVST的18至49岁女性的妊娠患病率高于同年龄段的普通人群。

结论

我们的研究结果提供了关于CVST以及伴有血小板减少症的CVST流行病学的最新综合数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/046d/8901465/4f663b1e5a75/RTH2-6-e12682-g003.jpg

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