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韩国全国范围内的过敏性肺炎流行病学、诊断和治疗研究。

Nationwide Study of the Epidemiology, Diagnosis, and Treatment of Hypersensitivity Pneumonitis in Korea.

机构信息

Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2024 Mar 18;39(10):e96. doi: 10.3346/jkms.2024.39.e96.

Abstract

BACKGROUND

Hypersensitivity pneumonitis (HP) is a condition with an uncertain global incidence, and information on its diagnosis and management is limited. This study aimed to address these knowledge gaps.

METHODS

This study utilized customized claims data from the Health Insurance Review and Assessment Service (HIRA) in South Korea from January 2010, to December 2021. Patients with HP were identified based on the diagnosis code (International Classification of Diseases, 10th Revision, J67) between 2011 and 2020. Incident HP cases were defined as new HP claims, excluding those with claims in the previous year. The study examined various factors such as age, sex, comorbidities, diagnostic methods, and treatment patterns. Additionally, multivariate logistic regression analysis was performed to identify risk factors associated with treatment initiation.

RESULTS

A total of 8,678 HP incident cases were confirmed, with age- and sex-adjusted annual incidence rates ranging from 1.14/100,000 in 2020 to 2.16/100,000 in 2012. The mean age of patients with incident HP was 52 years, with a higher incidence observed among males. Additionally, the most common comorbidity was asthma. Bronchoscopy was performed on 16.9% of patients, and 25.4% of patients did not receive treatment within 1 year of diagnosis. Among those who received treatment, prednisone was the most used systemic steroid, and azathioprine was the most commonly used second-line immunosuppressant. Factors associated with treatment initiation included the female sex, having asthma or gastroesophageal reflux disease (GERD), and undergoing bronchoscopy.

CONCLUSION

This study provides valuable insights into the incidence, diagnosis, and treatment patterns of HP in South Korea using nationwide medical claims data.

摘要

背景

过敏性肺炎(HP)是一种发病率不确定的疾病,关于其诊断和治疗的信息有限。本研究旨在填补这些知识空白。

方法

本研究利用了韩国健康保险审查与评估服务(HIRA)自 2010 年 1 月至 2021 年 12 月的定制索赔数据。2011 年至 2020 年间,根据诊断代码(国际疾病分类,第 10 版,J67)确定 HP 患者。新发生的 HP 病例定义为新的 HP 索赔,不包括前一年有索赔的病例。本研究检查了各种因素,如年龄、性别、合并症、诊断方法和治疗模式。此外,还进行了多变量逻辑回归分析,以确定与治疗开始相关的风险因素。

结果

共确认了 8678 例新发生的 HP 病例,年龄和性别调整后的年发病率从 2020 年的 1.14/100,000 到 2012 年的 2.16/100,000 不等。新发生 HP 的患者平均年龄为 52 岁,男性发病率较高。此外,最常见的合并症是哮喘。对 16.9%的患者进行了支气管镜检查,25.4%的患者在诊断后 1 年内未接受治疗。在接受治疗的患者中,泼尼松是最常用的全身性皮质类固醇,硫唑嘌呤是最常用的二线免疫抑制剂。与治疗开始相关的因素包括女性、哮喘或胃食管反流病(GERD)以及支气管镜检查。

结论

本研究使用全国性医疗索赔数据,提供了韩国 HP 的发病率、诊断和治疗模式的有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f758/10948259/bbf320933d81/jkms-39-e96-g001.jpg

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