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预计德国椎体骨髓炎的发病率将会增加,这对未来老龄化人口的医疗保健管理提出了严峻挑战。

The projected increase of vertebral osteomyelitis in Germany implies a demanding challenge for future healthcare management of aging populations.

机构信息

Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Center for Spinal Surgery, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Germany.

出版信息

Infection. 2024 Aug;52(4):1489-1497. doi: 10.1007/s15010-024-02243-8. Epub 2024 Apr 9.

Abstract

PURPOSE

Since an increase in the occurrence of native vertebral osteomyelitis (VO) is expected and reliable projections are missing, it is urgent to provide a reliable forecast model and make it a part of future health care considerations.

METHODS

Comprehensive nationwide data provided by the Federal Statistical Office of Germany were used to forecast total numbers and incidence rates (IR) of VO as a function of age and gender until 2040. Projections were done using autoregressive integrated moving average model on historical data from 2005 to 2019 in relation to official population projections from 2020 to 2040.

RESULTS

The IR of VO is expected to increase from 12.4 in 2019 to 21.5 per 100,000 inhabitants [95% CI 20.9-22.1] in 2040. The highest increase is predicted in patients over 75 years of age for both men and women leading to a steep increase in absolute numbers, which is fourfold higher compared to patients younger than 75 years. While the IR per age group will not increase any further after 2035, the subsequent increase is due to a higher number of individuals aged 75 years or older.

CONCLUSIONS

Our data suggest that increasing IR of VO will seriously challenge healthcare systems, particularly due to demographic change and increasing proportions of populations turning 75 years and older. With respect to globally fast aging populations, future health care policies need to address this burden by anticipating limitations in financial and human resources and developing high-level evidence-based guidelines for prevention and interdisciplinary treatment.

摘要

目的

由于预计会出现更多的原生性脊椎骨髓炎(VO)病例,且缺乏可靠的预测数据,因此急需提供一个可靠的预测模型,并将其纳入未来医疗保健的考量之中。

方法

利用德国联邦统计局提供的全国综合数据,根据年龄和性别,预测 2040 年之前 VO 的总病例数和发病率(IR)。使用自回归积分移动平均模型,根据 2005 年至 2019 年的历史数据,对 2020 年至 2040 年的官方人口预测数据进行了预测。

结果

预计 VO 的 IR 将从 2019 年的每 10 万人 12.4 例上升到 2040 年的每 10 万人 21.5 例[95%CI20.9-22.1]。男性和女性中 75 岁以上患者的发病率预计会增加最高,导致绝对数量急剧增加,比 75 岁以下的患者高四倍。虽然每个年龄组的 IR 在 2035 年后不会再增加,但后续的增加是由于 75 岁及以上的人口数量增加所致。

结论

我们的数据表明,VO 的发病率不断上升将严重挑战医疗保健系统,这主要是由于人口老龄化和 75 岁及以上人口比例的增加。鉴于全球人口老龄化速度较快,未来的医疗保健政策需要通过预测财政和人力资源的限制,并制定基于高级别证据的预防和跨学科治疗指南来应对这一负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dae/11289156/1abe276dd82a/15010_2024_2243_Fig1_HTML.jpg

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