From the Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre.
Department of Plastic Surgery, University of Groningen, University Medical Center Groningen.
Plast Reconstr Surg. 2023 Mar 1;151(3):581-591. doi: 10.1097/PRS.0000000000009919. Epub 2022 Nov 22.
Health care burden attributable to Dupuytren disease (DD) is largely unknown. The authors determined (1) the prevalence and incidence of DD, (2) the incidence of first surgical intervention, and (3) the lifetime risk of surgical intervention in the United Kingdom National Healthcare Service.
In this population-based dynamic cohort analysis, data of the Clinical Practice Research Datalink was linked to Hospital Episode Statistics, to characterize the diagnosis and surgical treatment of DD. Secular trends of incidence of DD diagnosis and first surgical treatment were calculated for 2000 to 2013. A multistate Markov model was designed to estimate the lifetime risk of first surgical intervention.
A total of 10,553,454 subjects were included in the analyses, 5,502,879 (52%) of whom were women. Of these, 38,707 DD patients were identified. Point prevalence in 2013 was 0.67% (99% CI, 0.66 to 0.68). The incidence of DD almost doubled from 0.30 (99% CI, 0.28 to 0.33) per 1000 person-years in 2000, to 0.59 (99% CI, 0.56 to 0.62) per 1000 person-years in 2013. The incidence of first surgical intervention similarly increased from 0.29 (99% CI, 0.23 to 0.37) to 0.88 (99% CI, 0.77 to 1.00) in the same period. A man or woman newly diagnosed with DD at age 65 has a lifetime risk of surgical intervention of 23% and 13%, respectively, showing only a very subtle decrease when diagnosed later in life.
DD is an important health condition in the older population, because prevalence and incidence rates have almost doubled in the past decade. Estimated lifetime risk of surgical treatment is relatively low, but almost twice in men compared with women.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
导致杜普伊特伦挛缩症（Dupuytren disease，DD）的健康负担在很大程度上尚不清楚。作者旨在：（1）确定 DD 的患病率和发病率；（2）首次手术干预的发病率；以及（3）在英国国家医疗服务体系中手术干预的终生风险。
在这项基于人群的动态队列分析中，将临床实践研究数据链接到医院发病统计数据，以描述 DD 的诊断和手术治疗情况。计算 2000 年至 2013 年期间 DD 诊断和首次手术治疗的发病率的时间趋势。设计了一个多状态马尔可夫模型来估计首次手术干预的终生风险。
共纳入 10553454 名受试者，其中 5502879 名（52%）为女性。其中，38707 名患者被诊断为 DD。2013 年的时点患病率为 0.67%（99%CI，0.66%至 0.68%）。DD 的发病率几乎翻了一番，从 2000 年的 0.30（99%CI，0.28 至 0.33）/1000 人年增至 2013 年的 0.59（99%CI，0.56 至 0.62）/1000 人年。同期，首次手术干预的发病率也从 0.29（99%CI，0.23 至 0.37）增加到 0.88（99%CI，0.77 至 1.00）。65 岁时新诊断为 DD 的男性或女性终生手术干预的风险分别为 23%和 13%，而在以后的生活中诊断出该病时，风险仅略有下降。
DD 是老年人群中的一个重要健康问题，因为过去十年中患病率和发病率几乎翻了一番。估计的终生手术治疗风险相对较低，但男性是女性的近两倍。
临床问题/证据水平：风险，III 级。
