Primatesta P, Goldacre M J
Department of Public Health and Primary Care, University of Oxford, UK.
Int J Epidemiol. 1995 Oct;24(5):922-8. doi: 10.1093/ije/24.5.922.
Crohn's disease and ulcerative colitis are chronic relapsing conditions. National hospital statistics in England only provide episode-based admission rates and cannot be used to identify multiple admissions per person. We used record linkage to provide a person-based profile of admission rates.
Age-standardized admission rates were calculated from the computer tapes of the Hospital In-patient Enquiry (HIPE) for 1970-1985 and the Oxford Record Linkage Study (ORLS) for the period 1970-1986. In addition, annual hospitalized prevalence, first hospital admission rates (as a proxy for incidence) and readmission rates were calculated for the Oxford population. Predictors of relapses were assessed by logistic regression models.
Episode-based admission rates for Crohn's disease increased over time, both nationally and in Oxford. In Oxford, hospitalized incidence rates showed no increase for Crohn's disease. Neither episode-based nor person-based rates increased for ulcerative colitis. Relapses resulting in hospital admission were more common for Crohn's disease than for ulcerative colitis. They increased over time. We showed the influence of some sociodemographic characteristics (age, social class, district of residence, operations) on relapses.
Data on episodes of hospital care for Crohn's disease showed an increase over time while data related to individuals in receipt of care showed no increase over time. Unlinked episodes of hospital care are of limited value when studying temporal trends for chronic conditions with multiple admissions.
克罗恩病和溃疡性结肠炎是慢性复发性疾病。英国的国家医院统计数据仅提供基于发作的入院率，无法用于识别每人的多次入院情况。我们使用记录链接来提供基于个人的入院率概况。
根据1970 - 1985年医院住院患者查询（HIPE）的计算机磁带以及1970 - 1986年牛津记录链接研究（ORLS）计算年龄标准化入院率。此外，还计算了牛津人群的年度住院患病率、首次住院率（作为发病率的替代指标）和再入院率。通过逻辑回归模型评估复发的预测因素。
在全国范围内以及牛津地区，克罗恩病基于发作的入院率均随时间增加。在牛津，克罗恩病的住院发病率未显示增加。溃疡性结肠炎基于发作和基于个人的发病率均未增加。因复发导致住院在克罗恩病中比在溃疡性结肠炎中更常见，且随时间增加。我们展示了一些社会人口学特征（年龄、社会阶层、居住地区、手术）对复发的影响。
克罗恩病的医院护理发作数据显示随时间增加，而与接受护理的个体相关的数据未显示随时间增加。在研究有多次入院的慢性疾病的时间趋势时，未关联的医院护理发作数据价值有限。
