Department of Neurosurgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.
Goffin Consultancy, Canterbury, UK.
Acta Neurochir (Wien). 2022 Jun;164(6):1535-1541. doi: 10.1007/s00701-022-05219-5. Epub 2022 May 5.
PURPOSE: Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction worldwide. However, the current incidence of DCM is poorly understood. The Hospital Episode Statistics (HES) database contains details of all secondary care admissions across NHS hospitals in England. This study aimed to use HES data to characterise surgical activity for DCM in England. METHODS: The HES database was interrogated for all cases of DCM between 2012 and 2019. DCM cases were identified from 5 ICD-10 codes. Age-stratified values were collected for 'Finished Consultant Episodes' (FCEs), which correspond to a patient's hospital admission under a lead clinician. Data was analysed to explore current annual activity and longitudinal change. RESULTS: 34,903 FCEs with one or more of the five ICD-10 codes were identified, of which 18,733 (53.6%) were of working age (18-64 years). Mean incidence of DCM was 7.44 per 100,000 (SD ± 0.32). Overall incidence of DCM rose from 6.94 per 100,000 in 2012-2013 to 7.54 per 100,000 in 2018-2019. The highest incidence was seen in 2016-2017 (7.94 per 100,000). The median male number of FCEs per year (2919, IQR: 228) was consistently higher than the median female number of FCEs per year (2216, IQR: 326). The rates of both emergency admissions and planned admissions are rising. CONCLUSIONS: The incidence of hospitalisation for DCM in England is rising. Health care policymakers and providers must recognise the increasing burden of DCM and act to address both early diagnoses and access to treatment in future service provision plans.
目的:退行性颈椎脊髓病(DCM)是全球成人脊髓功能障碍的最常见原因。然而,目前对 DCM 的发病率了解甚少。医院入院统计(HES)数据库包含英格兰国民保健署医院所有二级保健入院的详细信息。本研究旨在使用 HES 数据描述英格兰 DCM 的手术活动。
方法:2012 年至 2019 年期间,对 HES 数据库中所有 DCM 病例进行了检索。从 5 个 ICD-10 代码中确定了 DCM 病例。收集了“完成顾问就诊”(FCE)的年龄分层值,FCE 对应于患者在主治临床医生下的住院就诊。对数据进行了分析,以探索当前的年度活动和纵向变化。
结果:确定了 34903 例具有一个或多个 ICD-10 代码的 FCE,其中 18733 例(53.6%)处于工作年龄(18-64 岁)。DCM 的平均发病率为每 100000 人 7.44(标准差 ± 0.32)。总体 DCM 发病率从 2012-2013 年的每 100000 人 6.94 上升到 2018-2019 年的每 100000 人 7.54。发病率最高的是 2016-2017 年(每 100000 人 7.94)。每年男性 FCE 中位数(2919,IQR:228)始终高于女性每年 FCE 中位数(2216,IQR:326)。紧急入院和计划入院的比例都在上升。
结论:英格兰因 DCM 住院的发病率正在上升。医疗保健政策制定者和提供者必须认识到 DCM 负担的增加,并在未来的服务提供计划中采取行动,以解决早期诊断和获得治疗的问题。
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