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韩国感染性脊椎骨髓炎的发病和治疗趋势:一项全国性基于人群的研究。

Incidence and treatment trends of infectious spondylodiscitis in South Korea: A nationwide population-based study.

机构信息

Department of Orthopedic Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea.

Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, South Korea.

出版信息

PLoS One. 2023 Jun 29;18(6):e0287846. doi: 10.1371/journal.pone.0287846. eCollection 2023.


DOI:10.1371/journal.pone.0287846
PMID:37384614
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10309630/
Abstract

The incidence of infectious spondylodiscitis (IS) has increased in recent years due to an increase in the numbers of older patients with chronic diseases, as well as patients with immunocompromise, steroid use, drug abuse, invasive spinal procedures, and spinal surgeries. However, research focusing on IS in the general population is lacking. This study investigated the incidence and treatment trends of IS in South Korea using data obtained from the Health Insurance Review and Assessment Service. A total of 169,244 patients (mean age: 58.0 years) diagnosed from 2010 to 2019 were included in the study. A total of 10,991 cases were reported in 2010 and 18,533 cases in 2019. Hence, there was a 1.5-fold increase in incidence rate per 100,000 people from 22.90 in 2010 to 35.79 in 2019 (P < 0.05). The incidence rate of pyogenic spondylodiscitis per 100,000 people increased from 15.35 in 2010 to 33.75 in 2019, and that of tuberculous spondylodiscitis decreased from 7.55 in 2010 to 2.04 in 2019 (P < 0.05, respectively). Elderly individuals ≥ 60 years of age accounted for 47.6% (80,578 patients) of all cases of IS. The proportion of patients who received conservative treatment increased from 82.4% in 2010 to 85.8% in 2019, while that of patients receiving surgical treatment decreased from 17.6% to 14.2% (P < 0.05, respectively). Among surgical treatments, the proportions of corpectomy and anterior fusion declined, while proportion of incision and drainage increased (P < 0.05, respectively). The total healthcare costs increased 2.9-fold from $29,821,391.65 in 2010 to $86,815,775.81 in 2019 with a significant increase in the ratio to gross domestic product. Hence, this population-based cohort study demonstrated that the incidence rate of IS has increased in South Korea. The conservative treatment has increased, while the surgical treatment has decreased. The socioeconomic burden of IS has increased rapidly.

摘要

近年来,由于患有慢性病的老年患者人数增加,以及免疫功能低下、使用类固醇、药物滥用、侵袭性脊柱手术和脊柱手术的患者增加,感染性脊椎炎(IS)的发病率有所上升。然而,针对普通人群中 IS 的研究还很缺乏。本研究使用从健康保险审查和评估服务(Health Insurance Review and Assessment Service)获得的数据,调查了韩国 IS 的发病率和治疗趋势。共有 169244 名(平均年龄:58.0 岁)患者于 2010 年至 2019 年被诊断为 IS,其中 2010 年报告了 10991 例,2019 年报告了 18533 例。因此,发病率从 2010 年的每 10 万人 22.90 例增加到 2019 年的每 10 万人 35.79 例,增加了 1.5 倍(P < 0.05)。化脓性脊椎炎的发病率从 2010 年的每 10 万人 15.35 例增加到 2019 年的每 10 万人 33.75 例,而结核性脊椎炎的发病率从 2010 年的每 10 万人 7.55 例下降到 2019 年的每 10 万人 2.04 例(均 P < 0.05)。≥ 60 岁的老年人占 IS 总病例的 47.6%(80578 例)。接受保守治疗的患者比例从 2010 年的 82.4%增加到 2019 年的 85.8%,而接受手术治疗的患者比例从 17.6%下降到 14.2%(均 P < 0.05)。在手术治疗中,椎体切除术和前路融合术的比例下降,而切开引流术的比例增加(均 P < 0.05)。2010 年,IS 的总医疗费用为 2982.139165 美元,到 2019 年增加到 8681.577581 美元,增长了 2.9 倍,在国内生产总值中的占比显著增加。因此,这项基于人群的队列研究表明,韩国的 IS 发病率有所上升。保守治疗有所增加,而手术治疗有所减少。IS 的社会经济负担迅速增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/9ed8094ec85e/pone.0287846.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/86b5a122c092/pone.0287846.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/3a14d25e6f02/pone.0287846.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/9ed8094ec85e/pone.0287846.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/86b5a122c092/pone.0287846.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/3a14d25e6f02/pone.0287846.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741a/10309630/9ed8094ec85e/pone.0287846.g003.jpg

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[5]
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[7]
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[8]
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本文引用的文献

[1]
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Asian Spine J. 2022-10

[2]
Osteoporosis is a novel risk factor of infections and sepsis: A cohort study.

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[3]
Minimally invasive spine surgery as treatment for persistent infectious lumbar spondylodiscitis: a systematic review and meta-analysis.

J Spine Surg. 2022-3

[4]
Lumbar Spinal Steroid Injections and Infection Risk after Spinal Surgery: A Systematic Review and Meta-Analysis.

Asian Spine J. 2022-12

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Deep Spinal Infection after Outpatient Epidural Injections for Pain: A Retrospective Sample Cohort Study Using a Claims Database in South Korea.

Anesthesiology. 2021-6-1

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J Korean Neurosurg Soc. 2020-11

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A New Surgical Strategy for Infective Spondylodiscitis: Comparison Between the Combined Antero-Posterior and Posterior-Only Approaches.

Spine (Phila Pa 1976). 2020-10-1

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