Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
RAND Corporation, Arlington, Virginia, USA.
Neuroepidemiology. 2023;57(3):148-155. doi: 10.1159/000530535. Epub 2023 Apr 25.
Essential tremor (ET) is the most common tremor disorder, estimated to affect 7 million individuals in the USA. There is little empirical evidence on comorbidities among this population beyond higher prevalence of brain-related and stress-related disorders. This study aims to examine differences in the prevalence of the 31 Elixhauser comorbidities among ET patients compared to statistically similar control patients.
An extract from Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2018 to 2019 of adults aged 40-80 years with at least one claim with an ET diagnosis was propensity score matched to controls. Logistic regression was used to generate doubly robust adjusted odds ratios for each of the 31 Elixhauser comorbidities.
In these analyses, ET patients had significantly greater adjusted odds of depression, alcohol abuse, and other neurological disorders, as well as chronic pulmonary disease, renal failure, hyperthyroidism, and cardiac arrhythmias relative to controls. They also had lower odds of uncomplicated diabetes, congestive heart failure, metastatic cancer, paralysis, peripheral vascular disease, and fluid and electrolyte disorders.
A number of recent studies, including our own, suggest that psychiatric, neurologic, and stress-related disorders may be more prevalent among ET patients than controls. Additional differences in the prevalence of a range of medical comorbidities have also been variably reported across studies, suggesting that some combination of these might be more prevalent. Further studies would be of value in sorting through these associations.
特发性震颤（ET）是最常见的震颤障碍，据估计，在美国有 700 万人受其影响。除了与大脑和压力相关的疾病的发病率较高之外，针对该人群的合并症的实证证据很少。本研究旨在检查 ET 患者与统计学上相似的对照患者相比，31 种 Elixhauser 合并症的患病率差异。
从 2018 年至 2019 年，从 Optum 的去识别 Clinformatics® Data Mart 数据库（CDM）中提取了至少有一次 ET 诊断记录的 40-80 岁成年人的数据，使用倾向评分匹配对照。使用逻辑回归生成 31 种 Elixhauser 合并症的每一种的双稳健调整优势比。
在这些分析中，与对照组相比，ET 患者的抑郁、酒精滥用和其他神经障碍、慢性肺部疾病、肾衰竭、甲状腺功能亢进和心律失常的调整后优势比显著更高。他们的无并发症糖尿病、充血性心力衰竭、转移性癌症、瘫痪、外周血管疾病和液体及电解质紊乱的几率也较低。
包括我们自己在内的一些最近的研究表明，与对照组相比，精神、神经和与压力相关的疾病在 ET 患者中可能更为普遍。在不同的研究中，还报告了一系列医疗合并症的患病率存在差异，这表明其中一些合并症可能更为普遍。进一步的研究将有助于梳理这些关联。
