| アブストラクト | OBJECTIVE: To understand how prevalence estimates of single and multiple organ fibrosis have changed from 2012 to 2022. DESIGN: Retrospective population-based cohort study. SETTING: Data from primary (Clinical Practice Research Datalink Aurum) and secondary care (Hospital Episode Statistics Admitted Patient Care) electronic health records were used to conduct this study. PARTICIPANTS: Adults aged 18 years and older whose primary and secondary care records were available for research. MAIN OUTCOME MEASURE: Fibrotic conditions previously determined from a Delphi survey of clinicians; diagnoses were found in either primary or secondary care records. The primary analysis estimated the prevalence of both single and multiple organ fibrosis. A secondary analysis used Cox proportional hazards models to investigate the association between the time-updated number of fibrotic conditions and risk of death, adjusting for age and sex. RESULTS: The cohort consisted of 5 839 459 people with at least one fibrotic condition and a denominator of 18 784 962 people. Over the study period, prevalence of fibrotic conditions increased by 6.72%, and as of 2022, 19.95% (95% CI 19.92% to 19.98%) of adults had at least one fibrotic condition. The prevalence of multiple organ fibrosis increased from 4.78% (95% CI 4.76% to 4.79%) in 2012 to 8.51% (95% CI 8.50% to 8.53%) in 2022. In the year preceding diagnosis of single organ fibrosis, the median number of primary care consultations was 14 compared with 21 consultations for people with multiple organ fibrosis. Compared with people with single organ fibrosis, people with two fibrotic conditions had a mortality HR of 2.90 (95% CI 2.87 to 2.93), while people with three fibrotic conditions had a mortality HR of 5.22 (95% CI 5.14 to 5.30). CONCLUSIONS: The prevalence of single and multiple organ fibrosis has substantially increased over a decade. People with multiple organ fibrosis access healthcare more than people with single organ fibrosis and are at a greater risk of mortality. Multiple organ fibrosis is estimated to affect more than 3 million people in the UK and is increasing. Better understanding of patterns of fibrotic multimorbidity may help to aid earlier diagnosis and opportunities for reducing mortality. |
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| 投稿者 | Massen, Georgie May; Jenkins, Gisli; Allen, Richard J; Stewart, Iain; Scotton, Chris J; Chambers, Rachel; Longhurst, Hilary; Wain, Louise V; Navaratnam, Vidya; Quint, Jennifer K |
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| 組織名 | School of Public Health, Imperial College London, London, UK;g.massen21@imperial.ac.uk.;National Heart and Lung Institute, Imperial College London, London, UK.;Division of Public Health and Epidemiology, University of Leicester, Leicester,;England, UK.;NIHR Leicester Biomedical Research Centre, Leicester, England, UK.;National Heart and Lung Institute, Imperial College London, London, England, UK.;Faculty of Health Sciences, University of Exeter, Exeter, England, UK.;Department of Respiratory Medicine (UCL Respiratory), University College London,;London, England, UK.;Dyskeratosis Congenita (DC) Action, London, UK.;Leicestershire, UK.;The Institute for Lung Health, Leicester NIHR Biomedical Research Centre,;University of Leicester, Leicester, Leicestershire, UK.;Institute for Respiratory Health, The University of Western Australia, Perth,;Western Australia, Australia.;School of Public Health, Imperial College London, London, UK. |
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