Halmela Aleksi, Saari Emilia, Raitanen Jani, Koivisto Timo, Auvinen Anssi, Frösen Juhana
Dept of Epidemiology, Faculty of Social Sciences, Tampere University, Tampere, Finland.
Hemorrhagic Brain Pathology Research Group, Tampere University, Tampere, Finland.
Lancet Reg Health Eur. 2024 Sep 26;46:101072. doi: 10.1016/j.lanepe.2024.101072. eCollection 2024 Nov.
The few previous studies that have estimated the incidence of cerebral cavernous malformations (cavernomas) have reported incidence rates of 0.2-1.9/100,000 for diagnosed cavernomas. Our aim was to describe incidence trends of cavernomas by clinical presentation.
We conducted a retrospective cohort study of cavernomas diagnosed at two university hospitals in Finland (Kuopio University Hospital, KUH and Tampere University Hospital, TAUH). Cavernoma diagnoses during 2004-2020 were identified from the KUH and TAUH Care registry databases and verified from medical records and diagnostic imaging studies. We calculated the age-standardized incidence rates using the European standard population and analysed incidence trend and changes in trend by sex, age group, and calendar year using Poisson regression.
A total of 669 cavernoma diagnoses were identified during 2004-2020 in the combined KUH and TAUH population. The age-standardized incidence rate was 2.01/100,000 (95% confidence interval (CI) 1.85-2.16) for all cavernoma diagnoses, 1.25/100,000 (1.13-1.37) for asymptomatic, 0.75/100,000 (0.66-0.85) for symptomatic, and 0.46/100,000 (0.39-0.53) for ruptured cavernomas. No significant difference in the incidence of cavernoma diagnoses was seen between the KUH and TAUH populations or between the sexes. Incidence of cavernomas was highest at ages 40-59 years and low in those under 20 or over 80 years of age. Incidence of diagnosed cavernomas, especially asymptomatic, increased during the study period.
In our population-based study, incidence of cavernomas was higher than previously reported and increased during the study period. The burden imposed by cavernomas on healthcare system is considerable and increasing.
The Research Council of Finland, Kuopio University Hospital, Tampere University Hospital, and Wellbeing services county of Pirkanmaa.
之前仅有少数研究估算过脑海绵状血管畸形（海绵状瘤）的发病率，报告的已诊断海绵状瘤发病率为0.2 - 1.9/10万。我们的目的是按临床表现描述海绵状瘤的发病趋势。
我们对芬兰两家大学医院（库奥皮奥大学医院，KUH和坦佩雷大学医院，TAUH）诊断的海绵状瘤进行了一项回顾性队列研究。2004 - 2020年期间的海绵状瘤诊断信息从KUH和TAUH护理登记数据库中识别，并通过病历和诊断影像研究进行核实。我们使用欧洲标准人口计算年龄标准化发病率，并使用泊松回归分析按性别、年龄组和日历年划分的发病趋势及趋势变化。
在2004 - 2020年期间，KUH和TAUH合并人群中共识别出669例海绵状瘤诊断病例。所有海绵状瘤诊断的年龄标准化发病率为2.01/10万（95%置信区间（CI）1.85 - 2.16），无症状的为1.25/10万（1.13 - 1.37），有症状的为0.75/10万（0.66 - 0.85），破裂的海绵状瘤为0.46/10万（0.39 - 0.53）。KUH和TAUH人群之间或性别之间在海绵状瘤诊断发病率上没有显著差异。海绵状瘤发病率在40 - 59岁时最高，在20岁以下或80岁以上人群中较低。在研究期间，已诊断海绵状瘤的发病率，尤其是无症状的发病率有所增加。
在我们基于人群的研究中，海绵状瘤的发病率高于先前报告，且在研究期间有所增加。海绵状瘤给医疗系统带来的负担相当大且在增加。
芬兰研究理事会、库奥皮奥大学医院、坦佩雷大学医院和皮尔卡马区福利服务局。
