颈肌张力障碍(CD)发病率和诊断延误一个多民族的健康维护组织。(S36.004)

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摘要目的:确定发病率和描述诊断延迟的颈肌张力障碍(CD)在一个大型的、多民族的综合健康维护组织。背景:很少有CD发病率的研究。诊断的延迟没有得到系统的研究。设计/方法:CD病例中使用电子病历回顾> 300万名Kaiser Permanente加州北部(KPNC) 2003 - 2007。最后的诊断是由两个运动障碍专家的共识。发病率是标准化使用2000年美国人口普查。诊断延迟是评估通过比较医生访问CD之前诊断或一个等价的时间控制(索引日期)。控制匹配对年龄、性别和会员持续时间(1例:10控制)。使用逻辑回归调整优势比测定年龄,性别和会员持续时间。诊断延迟的频率和影响被结构化面试评估小组。结果:CD标准化,以2000年美国人口普查人口发病率为1.18/100000人年(py) (95 [percnt] C.I.:0.35,2.0;女人:0.93,男人:0.25)基于超过1540万py 200例。通过第七届十年发病率随着年龄的增加。CD诊断延迟的中位数730天。诊断更常见于CD索引日期前与控制包括特发性震颤(或68.1,95 [percnt] C.I. 28.2, 164.5),颈磁盘疾病(或3.83,95 [percnt] C.I. 2.83, 5.17),颈部扭伤/应变(或2.68,95 [percnt] C.I. 1.99, 3.62),焦虑(或2.24,95 [percnt] C.I. 1.63, 3.11)和抑郁(或1.94,95 [percnt] C.I. 1.4, 2.68)。50 (percnt)的CD患者采访报道诊断延迟;其中,75年[percnt]困难在工作和48 (percnt)困难家庭关系由于延迟。结论:CD女性发病率较高。诊断延迟是很常见的,不利影响。诊断前CD可能反映了共病情况,诊断错误或病原学的因素。支持:NIH-1RO1-NS046340 AHRQ-RO1-HS018413,肌张力障碍的医学研究基金会,KPNC,詹姆斯克拉克和莎伦

披露:LaHue博士没有披露。阿尔伯斯博士没有披露。高盛没有披露博士。博士Klingman没有披露。罗博士没有披露。马拉博士已经收到个人活动与EMD Serono补偿。Leimpeter博士没有披露。Fross博士没有披露。Comyns博士没有披露。顾博士没有披露。 Dr. Katz has received personal compensation for activities with Medtronic. Dr. Ozelius has nothing to disclose., Dr. Bressman has nothing to disclose. Dr. Saunders-Pullman has nothing to disclose. Dr. Comella has received personal compensation for activities with Ipsen, Merz, Allergan, Inc., Medtronic, Inc., Teva, US World Meds, Impax, and Acadia. Dr. Comella's institution has received research support from Ipsen, Merz, Allergan, Inc., the National Dr. Nelson has received personal compensation for activities with NeuroPace and Acumen, LLC. Dr. Van Den Eeden has received research support from Abbott Molecular, GlaxoSmithKline, and Takeda Pharmaceutical Company. Dr. Tanner has received personal compensation for activities with Pfizer Inc. as a consultant.