| アブストラクト | OBJECTIVES: To describe the epidemiology of slipped capital femoral epiphysis (SCFE), to examine associations with childhood obesity and socioeconomic deprivation, and to explore factors associated with diagnostic delays. DESIGN: Historic cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink and Hospital Episode Statistics. SETTING: All contacts with healthcare services, including emergency presentations, outpatient appointments, inpatient admissions and primary care visits, within the UK National Health Service. PATIENTS: All individuals <16 years old with a diagnosis of SCFE and whose electronic medical record was held by one of 650 primary care practices in the UK between 1990 and 2013. MAIN OUTCOME MEASURES: Annual incidence, missed opportunities for diagnosis and diagnostic delay. RESULTS: Over the 23-year period the incidence remained constant at 4.8 (95% CI 4.4 to 5.2) cases per 100,000 0-16-year-olds. There was a strong association with socioeconomic deprivation. Predisease obesity was also strongly associated with SCFE; mean predisease z-score of body mass index was 1.43 (95% CI 1.20 to 1.68) compared with the UK reference mean. Diagnostic delays were common, with most children (75.4%) having multiple primary care contacts with relevant symptomatology, and those who presented with knee pain having significantly longer diagnostic delay (median 161 (IQR 27-278) days) than those with hip pain (20 (5-126)) or gait abnormalities (21 (7-72)). CONCLUSIONS: SCFE has a strong association with both area-level socioeconomic deprivation and predisease obesity. The majority of patients with SCFE are initially misdiagnosed and those presenting with knee pain are particularly at risk. |
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| ジャーナル名 | Archives of disease in childhood |
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| Pubmed追加日 | 2017/7/1 |
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| 投稿者 | Perry, Daniel C; Metcalfe, David; Costa, Matthew L; Van Staa, Tjeerd |
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| 組織名 | Institute of Translational Medicine, University of Liverpool, Liverpool, UK.;Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences;(NDORMS), University of Oxford, Oxford, UK.;Health eResearch Centre, University of Manchester, Manchester, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28663349/ |
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