Abstract
BackgroundDupuytren's contracture is a condition of the palmar fascia involving contractures of the fascia and skin in the hand. Current treatment for Dupuytren's contracture is mainly limited to surgery. In the Netherlands, little is known about the prevalence of Dupuytren's contracture. In this study we determined the prevalence of patients with a hospitalization for Dupuytren's contracture in the Netherlands and characterized their (re)hospitalizations.MethodsFrom the PHARMO database, which consists of multiple observational databases linked on a patient level, all patients hospitalized for Dupuytren's contracture between 2004 and 2007 were included in the source population (ICD-9-CM code 728.6). Numbers from this source population were used to provide estimates of hospitalizations for Dupuytren's contracture in the Netherlands. Patients with a medical history in the PHARMO database of at least 12 months before their hospitalization were included in the study cohort and followed until end of data collection, death, or end of study period, whichever occurred first. Type of admission, length of stay, recorded procedures, treating specialty, number of rehospitalizations for Dupuytren's contracture, and time to first rehospitalization were assessed.ResultsOf 3, 126 patients included in the source population, 3, 040 were included in the study population. The overall prevalence of patients with a hospitalization for Dupuytren's contracture was 0.04%, with the highest prevalence (0.25%) among 60-79 year old males. The majority (85%) of all hospitalizations were day-case admissions. Of the admitted inpatients (15%) the majority (81%) had one overnight stay in the hospital. The most common recorded procedure was fasciectomy (87%) and 78% of patients was treated by a plastic surgeon. During a median (IQR) follow-up of 2.9 (1.8-4.0) years, 523 patients were rehospitalized for Dupuytren's contracture. The median (IQR) time to first rehospitalization was 0.8 (0.4-1.9) years.ConclusionsThis study is a first exploration of Dupuytren's contracture in the Netherlands based on hospitalizations, showing a prevalence of 0.25% among 60-79 year old males. Future studies should also address outpatient procedures to get a complete picture of the treatment of Dupuytren's contracture. In addition, patients not yet treated should be included to be able to estimate the prevalence of Dupuytren's contracture.
Highlights
Dupuytren’s contracture is a condition of the palmar fascia involving contractures of the fascia and skin in the hand
The diagnosis is based on the presence of fibromatous nodule formations in the palmar fascia, which slowly progress to cords leading
Setting Data for this retrospective cohort study were obtained from the PHARMO Record Linkage System (PHARMO RLS), a population-based patient centric data tracking system including high quality and complete information linked on a patient level of, among other things, patient demographics, drug dispensing records from community pharmacies and hospital discharge records of approximately 2.5 million individuals from 1998 and still ongoing in defined areas throughout the Netherlands
Summary
Dupuytren’s contracture is a condition of the palmar fascia involving contractures of the fascia and skin in the hand. Dupuytren’s contracture is a slowly progressing, usually painless condition of the palmar fascia involving contractures of the fascia and skin in the hand [1]. Several epidemiologic studies in other European countries mention a prevalence that varies widely from 4 to 11 percent, with highest rates in Northern European countries [3]. This geographic variability may be due to a genetic element, environmental factor, or a combination of the two [3]. Some studies suggest that a lipid disorder may be an etiopathogenic factor for Dupuytren’s contracture [10,11]
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