| 摘要: | 背景：流行病學研究顯示，近年來亞洲胃食道逆流疾病(Gastroesophageal reflux disease, GERD)的盛行率快速增加，患者住院次數可以反映有關疾病的負擔。本研究的目的是在描述台灣胃食道逆流住院次數、胃食道逆流相關疾病之住院次數占總住院次數之比例及其風險因子。
方法：從台灣全民健保資料庫住院醫?費用清單明細檔（2004-2009年）之ICD碼中挑選胃食道逆流相關疾病（包括食道逆流、食道發炎、食道裂孔疝氣、食道狹窄及食道腺癌）患者，並分析胃食道逆流相關疾病之ICD碼出現在主診斷碼或任一診斷時的住院次數、及此住院次數占總住院次數之比例(簡稱住院比率、以每一萬住院次數為單位)，並探討其與人口學特質之關係。
結果：平均每年因胃食道逆流相關疾病住院的次數，分別為食道逆流50.5次/每1萬次、食道發炎44.4次/每1萬次、食道裂孔疝氣7.4次/每1萬次、食道狹窄2.3次/每1萬次及食道腺癌3.0次/每1萬次，在每一種疾病中，以主診斷住院的比率分別為17.7%、19.5%、14.2%、64.1%及85.4%。分析每一種疾病之住院次數占總住院次數之比例，食道逆流及食道發炎不論是以主診斷碼挑出或以任一診斷碼挑出所計算之比例，皆呈現逐年上升的趨勢（兩者皆P < 0.0001），食道狹窄若以主診斷碼挑出時，此比例則呈現逐年下降的趨勢（P < 0.001）。男性及老人是胃食道逆流相關疾病住院的風險因子。住在高度都市化市鎮是食道腺癌住院的環境風險因子。
結論：台灣胃食道逆流相關疾病之住院次數占總住院次數之比例有增加的趨勢，此疾病負擔的重要性及一些可能的環境風險因子。
Background: Epidemiological studies showed that gastroesophageal reflux disease (GERD) has become more prevalent among Asians in the last decade. Data from hospital discharges may reflect the disease burden such as prevalence and severe forms of GERD. We aimed to describe the characteristics and time trends of Taiwanese patients with GERD-related hospitalizations and the associated risk factors.
Methods: Data from National Health Insurance Research Database in Taiwan were used to study the demographic characteristics of hospitalizations associated with GERD during 2004-2009.
Results: Average annual proportion rate per 10,000 hospitalizations related to esophageal reflux, reflux esophagitis, hiatal hernia, esophageal stricture, and esophageal adenocarcinoma were 50.5, 44.4, 7.4, 2.3, and 3.0, respectively; among them, 17.7%, 19.5%, 14.2%, 64.1%, and 85.4% were discharged as a primary diagnosis, respectively. Time trends for GERD-related hospitalization increased for esophageal reflux and reflux esophagitis (trend test P < 0.0001, P < 0.0001) irrespective of primary or secondary diagnosis, but decreased for esophageal stricture as primary diagnosis (P < 0.001), and remained stable for other forms of GERD. Male and old age are independent risk factors for all forms of GERD-related hospitalizations. Residence in highly urbanization areas are independent environmental risk factors of esophageal adenocarcinoma.
Conclusions: The large number of inpatients with GERD-related diagnoses in Taiwan during 2004-2009 highlights the increasing importance of the disease burden and the possible environmental risk factors. |
