目的:为了表征流行病学,相关并发症,以及全国纵向健康保险数据库中眶底骨折的危险因素。
方法:分析了2001年至2011年间台湾国民健康保险研究数据库中随机选择的100万注册居民的索赔数据,作为回顾性队列审查的一部分。使用眼眶底骨折的国际疾病分类-9诊断代码(闭合:802.6;开放:802.7)鉴定患者。根据程序代码将病例分为手术或非手术,并进行统计学比较。
结果:从2001年到2011年,在9,836,431人年(平均发病率:6.78人/100,000/年)的总风险人群中,有663例患者被诊断为眶底骨折。213例(32%)患者进行了手术治疗。接受手术治疗的患者比未接受手术治疗的患者年轻(平均年龄25.3±13.6岁与34.2±18.6年,P<0.001)。诊断复视是手术治疗的一个显著相关因素(非手术组2.2%与手术组6.6%,P=0.007)。男性(校正风险比[aHR]=2.1,95%置信区间[CI]:1.79-2.49)和低月收入(aHR=1.76,95%CI:1.16-2.67)是眶底骨折的危险因素。
结论:2001年至2011年间,台湾人群眶底骨折的发生率增加。男性和低收入患者的眶底骨折风险增加。有必要进行更多的研究,以阐明哪些因素正在推动该国家人群中眼眶骨折的发病率不断上升。
OBJECTIVE: To characterize the epidemiology, associated complications, and risk factors of orbital floor fractures in a nationwide longitudinal health insurance database.
METHODS: Claims data from a million randomly selected registered residents from the Taiwan National Health Insurance Research Database were analyzed between 2001 and 2011 as part of a retrospective cohort review. Patients were identified using the International Classification of Disease-9 diagnosis codes for orbital floor fracture (closed: 802.6; open: 802.7). The cases were categorized as surgical or nonsurgical based on the procedure codes and compared statistically.
RESULTS: From 2001 to 2011, 663 patients were diagnosed with orbital floor fractures out of a total population at risk of 9,836,431 person-years (average incidence: 6.78 persons/100,000/year) with overall increasing incidence. Surgical treatments were performed in 213 (32%) patients. Patients who received surgical treatment were younger than those who did not (mean age 25.3 ± 13.6 years vs. 34.2 ± 18.6 years, P < 0.001). The diagnosis with diplopia was a significantly associated factor for surgical treatment (2.2% in nonsurgery group vs. 6.6% in surgery group, P = 0.007). Male gender (adjusted hazard ratios [aHR] = 2.1, 95% confidence interval [CI]: 1.79-2.49) and low monthly income (aHR = 1.76, 95% CI: 1.16-2.67) were the risk factors for orbital floor fracture.
CONCLUSIONS: The incidence of orbital floor fractures increased in the Taiwanese population between 2001 and 2011. Men and low income patients were at increased risk of orbital floor fracture. More research is necessary to clarify what factors are driving the escalating incidence of orbital fractures in this national population.