Université de Bretagne Occidentale (UBO), Laboratoire de Traitement de l'Information Médicale (LATIM) - UMR 1101, 22, rue Camille-Desmoulins, 29200 Brest, France.
Université de Bretagne Occidentale (UBO), Laboratoire de Traitement de l'Information Médicale (LATIM) - UMR 1101, 22, rue Camille-Desmoulins, 29200 Brest, France.
Orthop Traumatol Surg Res. 2024 Sep;110(5):103788. doi: 10.1016/j.otsr.2023.103788. Epub 2023 Dec 7.
Over the past decades, total shoulder arthroplasty (TSA) procedures have steadily increased in the United States and Europe. In France, the number of shoulder surgeries rose by 24.5% between 2012 and 2018, but no study has yet analyzed TSA trends based on patient characteristics. Therefore, the aim of our study was to use the French healthcare database to (1) analyze growth trends based on the patient's sex, age, and comorbidity profile and (2) estimate the most appropriate incidence rate (IR) projections to the year 2070.
We hypothesize that in France, the upward trends are different for each sex and age group.
This study was conducted in France from 2009 to 2019 based on the French healthcare database (SNDS), which contains all nationwide procedures. Patients were analyzed by sex, age group (<65 years, 65-74 years, ≥75 years), and comorbidity profile (4 levels). IR trends per 100,000 population were inferred by patient age, sex, and comorbidity using data from the French hospital discharge database (PMSI) and population forecasts and censuses from the French National Institute of Statistics and Economic Studies (INSEE). Linear, Poisson, logistic, and Gompertz projection models were created to forecast IRs to the year 2070.
Between 2009 and 2019, there was a sharper increase in IR in males (+155%; from 6.0 to 15.3) than in females (+118%; from 16.2 to 35.3) across all age groups. This increase was most significant in those younger than 65 years (+112%; from 2.3 to 4.9), in both males (+129%; from 2.1 to 4.8) and females (+99%; from 2.5 to 5.0). From 2012 to 2019, the proportion of patients with mild comorbidities increased by +92% (from 5,435 to 10,410 TSAs, i.e., from 56% to 61% of total procedures), unlike the other comorbidity profiles. All the projections modeled the data from 2009 to 2019 with minor deviations. However, the logistic projection was the most likely, with a 45% increase in the IR for the overall population by 2070 (from 17,175 to 25,338 TSAs), which will start to plateau in 2050.
The IR has risen sharply in the overall population, as in all age, sex, and comorbidity categories, with the most significant growth seen in the<65 and 65-74 age groups and a shift toward patients with milder comorbidities. According to our projections, the IR will continue to be more significant in older patients, except for males, for whom the IR for those 65 to 74 years old will exceed that of those 75 and older around 2030. In the longer term, the IRs follow a logistic trend, reaching a plateau around 2050. Therefore, an increase in healthcare burden is to be expected to meet the growing demand for TSAs.
IV; Descriptive epidemiological study.
在过去的几十年中，美国和欧洲的全肩关节置换术（TSA）手术数量稳步增加。在法国，2012 年至 2018 年间肩部手术数量增长了 24.5%，但尚无研究基于患者特征分析 TSA 趋势。因此，我们的研究目的是使用法国医疗保健数据库：(1) 分析基于患者性别、年龄和合并症状况的增长趋势；(2) 估计最合适的发病率 (IR) 预测值至 2070 年。
我们假设法国的上升趋势因性别和年龄组而异。
这项研究是在法国进行的，时间跨度为 2009 年至 2019 年，基于法国医疗保健数据库（SNDS），其中包含所有全国性手术。患者按性别、年龄组（<65 岁、65-74 岁、≥75 岁）和合并症状况（4 个级别）进行分析。通过使用来自法国医院出院数据库（PMSI）的患者年龄、性别和合并症数据以及法国国家统计局和经济研究研究所（INSEE）的人口预测和人口普查数据，推断出每 10 万人口的发病率趋势。为了预测 2070 年的发病率，创建了线性、泊松、逻辑和 Gompertz 预测模型。
2009 年至 2019 年间，所有年龄组中，男性（+155%；从 6.0 增加到 15.3）的发病率增长高于女性（+118%；从 16.2 增加到 35.3）。在年龄<65 岁的人群中，这种增长更为显著（+112%；从 2.3 增加到 4.9），男性（+129%；从 2.1 增加到 4.8）和女性（+99%；从 2.5 增加到 5.0）。从 2012 年到 2019 年，轻度合并症患者的比例增加了+92%（从 5435 增加到 10410 TSA，即从总手术的 56%增加到 61%），而其他合并症状况则不然。所有模型都用较小的偏差来模拟 2009 年至 2019 年的数据。然而，逻辑预测是最有可能的，到 2070 年，总体人口的发病率将增加 45%（从 17175 增加到 25338 TSA），到 2050 年，这一增长将趋于平稳。
在所有年龄、性别和合并症类别中，发病率均急剧上升，在<65 和 65-74 岁年龄组中增长最为显著，并且向合并症较轻的患者转移。根据我们的预测，发病率在老年患者中仍将更为显著，除了 65-74 岁的男性患者，到 2030 年，他们的发病率将超过 75 岁及以上的男性患者。从长期来看，发病率呈逻辑趋势，到 2050 年左右达到平台期。因此，预计医疗保健负担将增加，以满足不断增长的 TSA 需求。
IV；描述性流行病学研究。
