Trends in the incidence of newly diagnosed cerebral cavernous malformations in Finland: a population-based retrospective cohort study

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES Lancet Regional Health-Europe Pub Date : 2024-09-26 DOI:10.1016/j.lanepe.2024.101072

Aleksi Halmela , Emilia Saari , Jani Raitanen , Timo Koivisto , Anssi Auvinen , Juhana Frösen

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Abstract

Background

The few previous studies that have estimated the incidence of cerebral cavernous malformations (cavernomas) have reported incidence rates of 0.2–1.9/100,000 for diagnosed cavernomas. Our aim was to describe incidence trends of cavernomas by clinical presentation.

Methods

We conducted a retrospective cohort study of cavernomas diagnosed at two university hospitals in Finland (Kuopio University Hospital, KUH and Tampere University Hospital, TAUH). Cavernoma diagnoses during 2004–2020 were identified from the KUH and TAUH Care registry databases and verified from medical records and diagnostic imaging studies. We calculated the age-standardized incidence rates using the European standard population and analysed incidence trend and changes in trend by sex, age group, and calendar year using Poisson regression.

Findings

A total of 669 cavernoma diagnoses were identified during 2004–2020 in the combined KUH and TAUH population. The age-standardized incidence rate was 2.01/100,000 (95% confidence interval (CI) 1.85–2.16) for all cavernoma diagnoses, 1.25/100,000 (1.13–1.37) for asymptomatic, 0.75/100,000 (0.66–0.85) for symptomatic, and 0.46/100,000 (0.39–0.53) for ruptured cavernomas. No significant difference in the incidence of cavernoma diagnoses was seen between the KUH and TAUH populations or between the sexes. Incidence of cavernomas was highest at ages 40–59 years and low in those under 20 or over 80 years of age. Incidence of diagnosed cavernomas, especially asymptomatic, increased during the study period.

Interpretation

In our population-based study, incidence of cavernomas was higher than previously reported and increased during the study period. The burden imposed by cavernomas on healthcare system is considerable and increasing.

Funding

The Research Council of Finland, Kuopio University Hospital, Tampere University Hospital, and Wellbeing services county of Pirkanmaa.

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芬兰新诊断出的脑海绵畸形发病率趋势：基于人群的回顾性队列研究

背景以往对脑海绵状畸形（海绵状瘤）发病率进行估算的少数研究报告称，确诊海绵状瘤的发病率为 0.2-1.9/100,000 。我们的目的是根据临床表现描述海绵状瘤的发病趋势。方法我们对芬兰两所大学医院（库奥皮奥大学医院（Kuopio University Hospital）和坦佩雷大学医院（Tampere University Hospital））诊断出的海绵状瘤进行了一项回顾性队列研究。研究人员从库奥皮奥大学医院和坦佩雷大学医院的护理登记数据库中找到了2004-2020年期间诊断出的海绵状瘤，并通过病历和影像诊断研究进行了核实。我们使用欧洲标准人口计算了年龄标准化发病率，并使用泊松回归分析了不同性别、年龄组和日历年的发病趋势和趋势变化。所有海绵体瘤的年龄标准化发病率为 2.01/100,000（95% 置信区间 (CI)：1.85-2.16），无症状海绵体瘤的年龄标准化发病率为 1.25/100,000（1.13-1.37），有症状海绵体瘤的年龄标准化发病率为 0.75/100,000（0.66-0.85），破裂海绵体瘤的年龄标准化发病率为 0.46/100,000（0.39-0.53）。KUH和TAUH人群之间或男女之间的海绵体瘤诊断率没有明显差异。海绵状瘤的发病率在 40-59 岁的人群中最高，而在 20 岁以下或 80 岁以上的人群中较低。在我们这项基于人群的研究中，海绵体瘤的发病率高于之前的报道，并且在研究期间有所增加。海绵状瘤给医疗系统造成的负担相当大，而且还在不断增加。经费由芬兰研究委员会、库奥皮奥大学医院、坦佩雷大学医院和皮尔坎马县福利服务机构提供。

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.