Dupuytren's disease: Prevalence, incidence, and lifetime risk of surgical intervention A population-based cohort analysis.
Broekstra DC., Kuo RYL., Burn E., Prieto-Alhambra D., Furniss D.
BACKGROUND: Healthcare burden due to Dupuytren's disease (DD) is largely unknown. We determined 1) the prevalence and incidence of DD, 2) incidence of first surgical intervention, and 3) lifetime risk of surgical intervention in the UK National Healthcare Service (NHS). METHODS: In this population-based dynamic cohort analysis, data of the Clinical Practice Research Datalink (CPRD) was linked to Hospital Episode Statistics (HES), to characterize the diagnosis and surgical treatment of DD. Secular trends of incidence of DD diagnosis and first surgical treatment were calculated for 2000-2013. A multi-state Markov model was designed to estimate the lifetime risk of first surgical intervention. RESULTS: A total of 10,553,454 subjects were included in the analyses, 5,502,879 (52%) females. 38,707 DD patients were identified. Point prevalence in 2013 was 0.67% (99%CI: 0.66-0.68). Incidence of DD almost doubled from 0.30 (99%CI: 0.28-0.33)/ 1000 person-years in 2000, to 0.59 (99%CI: 0.56-0.62) in 2013. Incidence of first surgical intervention similarly increased from 0.29 (99%CI: 0.23-0.37) to 0.88 (99%CI: 0.77-1.00) in the same period. A man or woman newly diagnosed with DD at age 65 has a lifetime risk of surgical intervention of 23% and 13% respectively, showing only a very subtle decrease when diagnosed later in life. CONCLUSIONS: DD is an important health condition in the elderly population, since prevalence and incidence rates have almost doubled in the last decade. Estimated lifetime risk of surgical treatment is relatively low, but almost twice in males compared with females.