School of Life Course and Population Sciences, King's College London, Addison House, Guy's Campus, London, SE1 1UL, UK.
Faculty of Environmental and Life Sciences, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK.
Eur J Pediatr. 2024 Aug;183(8):3299-3307. doi: 10.1007/s00431-024-05590-8. Epub 2024 May 9.
The aim of this research was to describe the epidemiology, presentation and healthcare use in primary care for foot and ankle problems in children and young people (CYP) across England. We undertook a population-based cohort study using data from the Clinical Practice Research Datalink Aurum database, a database of anonymised electronic health records from general practices across England. Data was accessed for all CYP aged 0-18 years presenting to their general practitioner between January 2015 and December 2021 with a foot and/or ankle problem. Consultation rates were calculated and used to estimate numbers of consultations in an average practice. Hierarchical Poisson regression estimated relative rates of consultations across sociodemographic groups and logistic regression evaluated factors associated with repeat consultations. A total of 416,137 patients had 687,753 foot and ankle events, of which the majority were categorised as "musculoskeletal" (34%) and "unspecified pain" (21%). Rates peaked at 601 consultations per 10,000 patient-years among males aged 10-14 years in 2018. An average practice might observe 132 (95% CI 110 to 155) consultations annually. Odds for repeat consultations were higher among those with pre-existing diagnoses including juvenile arthritis (OR 1.73, 95% CI 1.48 to 2.03). Conclusions: Consultations for foot and ankle problems were high among CYP, particularly males aged 10 to 14 years. These data can inform service provision to ensure CYP access appropriate health professionals for accurate diagnosis and treatment. What is Known: • Foot and ankle problems can have considerable impact on health-related quality of life in children and young people (CYP). • There is limited data describing the nature and frequency of foot and ankle problems in CYP. What is New: • Foot and ankle consultations were higher in English general practice among CYP aged 10 to 14 years compared to other age groups, and higher among males compared to females. • The high proportion of unspecified diagnoses and repeat consultations suggests there is need for greater integration between general practice and allied health professionals in community-based healthcare settings.
本研究旨在描述英格兰儿童和青少年（CYP）足部和踝关节问题在初级保健中的流行病学、表现和医疗保健利用情况。我们使用来自英格兰全科实践的匿名电子健康记录 Clinical Practice Research Datalink Aurum 数据库，开展了一项基于人群的队列研究。数据获取了 2015 年 1 月至 2021 年 12 月期间因足部和/或踝关节问题向全科医生就诊的所有 0-18 岁 CYP。计算了就诊率，并用于估计平均实践中的就诊次数。分层泊松回归估计了社会人口统计学群体之间的就诊相对率，逻辑回归评估了与重复就诊相关的因素。共有 416137 名患者有 687753 例足部和踝关节事件，其中大多数被归类为“肌肉骨骼”（34%）和“未特指疼痛”（21%）。2018 年，10-14 岁男性的就诊率最高，每 10000 名患者-年有 601 次就诊。平均实践中，每年可能观察到 132 次（95%CI110-155 次）就诊。与存在幼年特发性关节炎等预先存在的诊断相比，重复就诊的可能性更高（OR1.73，95%CI1.48-2.03）。结论：CYP 足部和踝关节问题就诊率高，尤其是 10-14 岁男性。这些数据可以为服务提供提供信息，以确保 CYP 能够获得适当的卫生专业人员，以进行准确的诊断和治疗。已知情况：•足部和踝关节问题会对儿童和青少年（CYP）的健康相关生活质量产生重大影响。•关于 CYP 足部和踝关节问题的性质和频率的数据有限。新发现：•与其他年龄组相比，10-14 岁的 CYP 在英格兰普通实践中足部和踝关节就诊率更高，与女性相比，男性就诊率更高。•未特指的诊断和重复就诊的比例很高，这表明在社区为基础的医疗保健环境中，普通实践和联合卫生专业人员之间需要更大的整合。
