TY - T1的颈肌张力障碍(CD)发病率和诊断延误一个多民族的健康维护组织。乔(S36.004) JF -首页神经-神经学六世- 84 - 14补充SP - S36.004 AU -萨拉LaHue盟凯萨琳Albers AU -塞缪尔高盛盟Jeffrey Klingman AU - Raymond Lo盟康尼马拉AU -紫水晶Leimpeter AU -罗宾Fross盟凯萨琳Comyns盟Zhuqin顾AU -玛雅Katz盟劳丽Ozelius盟-苏珊Bressman AU -瑞秋Saunders-Pullman盟辛西娅·考米拉盟Lorene Nelson AU -斯蒂芬·范Eeden盟卡罗琳·坦纳Y1 - 2015/04/06 UR - //www.ez-admanager.com/content/84/14_Supplement/S36.004.abstract N2 -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。DESIGN/METHODS: CD cases were identified using electronic medical record review in > 3 million members of Kaiser Permanente Northern California (KPNC) during 2003-2007. Final diagnosis was determined by consensus of two movement disorders specialists. Incidence rates were standardized using the 2000 U.S. Census population. Diagnostic delay was assessed by comparing physician visits before CD diagnosis or an equivalent time in controls (index date). Controls were matched for age, sex and membership duration (1case:10controls). Odds ratios were determined using logistic regression adjusted for age, gender and membership duration. The frequency and impact of diagnostic delay were assessed by structured interviews in a subgroup. RESULTS: CD incidence standardized to the US 2000 Census population was 1.18/100,000 person-years (p-y) , (95[percnt] C.I.: 0.35, 2.0; women: 0.93, men: 0.25) based on 200 cases over 15.4 million p-y. Incidence increased with age through the 7th decade. CD diagnosis was delayed a median of 730 days. Diagnoses more common in CD vs. controls before index date included essential tremor (OR 68.1, 95[percnt] C.I. 28.2, 164.5), cervical disk disease (OR 3.83, 95[percnt] C.I. 2.83,5.17), neck sprain/strain (OR 2.68 , 95[percnt] C.I. 1.99, 3.62), anxiety (OR 2.24, 95[percnt] C.I. 1.63,3.11) and depression (OR 1.94, 95[percnt] C.I. 1.4, 2.68 ). 50[percnt] of CD patients interviewed reported diagnostic delay; of these, 75[percnt] had difficulties at work and 48[percnt] difficulties with family relationships due to the delay. CONCLUSIONS: CD incidence is higher in women. Diagnostic delay is common, with adverse impacts. Diagnoses preceding CD may reflect comorbid conditions, diagnostic errors or etiologic factors. Support: NIH-1RO1-NS046340, AHRQ-RO1-HS018413, Dystonia Medical Research Foundation, KPNC, James & Sharron ClarkDisclosure: Dr. LaHue has nothing to disclose. Dr. Albers has nothing to disclose. Dr. Goldman has nothing to disclose. Dr. Klingman has nothing to disclose. Dr. Lo has nothing to disclose. Dr. Marras has received personal compensation for activities with EMD Serono. Dr. Leimpeter has nothing to disclose. Dr. Fross has nothing to disclose. Dr. Comyns has nothing to disclose. Dr. Gu has nothing to disclose. 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.Wednesday, April 22 2015, 4:00 pm-5:45 pm ER -