Table 5.
Hospital surgical procedure rates among ACH cases vs controls (CPRD HES-linked cohort)
| Procedures by body system | Specific procedures | ||||||
|---|---|---|---|---|---|---|---|
| Body system | n, ER per 100PY* | RR (95% CI) | Type | n, ER per 100PY* | RR (95% CI) | ||
| Cases (N = 275) | Controls (N = 1064) | Cases (N = 275) | Controls (N = 1064) | ||||
| Any procedure | 265, 5.15 | 108, 0.53 | 9.83 (7.09–13.61)** | – | – | – | – |
| Orthopaedic | 141, 2.74 | 53, 0.26 | 10.63 (6.97–16.22)** | – | – | – | – |
| Spinal | 76, 1.48 | 21, 0.10 | 14.46 (8.73–23.94)** | Spinal decompression | 69, 1.34 | 21, 0.10 | 13.13 (7.87–21.89)** |
| Foramen magnum decompression | 7, 0.14 | 0, 0.0 | Cases only | ||||
| Limb | 65, 1.26 | 32, 0.16 | 8.10 (4.22–15.56)** | Bone fixation† | 44, 0.86 | 11, 0.05 | 15.99 (7.16–35.75)** |
| Hip/knee replacement | 10, 0.19 | 21, 0.10 | 1.90 (0.64–5.67) | ||||
| Limb lengthening | 10, 0.19 | 0, 0.0 | Cases only | ||||
| Brace provision | < 5, NC | 0, 0.0 | Cases only | ||||
| ENT | 104, 2.02 | 48, 0.23 | 8.62 (5.01–14.82)** | Grommet insertion | 66, 1.28 | 20, 0.10 | 13.15 (5.55–31.17)** |
| Tonsillectomy/adenoidectomy | 23, 0.45 | 23, 0.11 | 3.99 (2.25–7.07)** | ||||
| Hearing Aid | 6, 0.12 | < 5, NC | NC | ||||
| Tympanoplasty | 9, 0.18 | < 5, NC | NC | ||||
| Neurological | 7, 0.12 | 0, 0.0 | Cases only | Shunt/ventriculostomy | 7, 0.14 | 0, 0.0 | Cases only |
| Respiratory | 11.0, 0.21 | < 5, NC | NC | Tracheostomy | < 5, NC | 0, 0.0 | Cases only |
| Ventilation | 10, 0.19 | < 5, NC | NC | ||||
| Cardiovascular | < 5, NC | < 5, NC | NC | Cardiac stent | < 5, NC | < 5, NC | NC |
ACH Achondroplasia; CI Confidence interval; CPRD Clinical Practice Research Database; ENT Ear, nose and throat; ER Event rate; HES Hospital Episode Statistics; N Total number of individuals; n Number of occurrences of procedure of interest; NC Not calculated (due to small cell size); PY Person years; RR Rate ratio
*Where the number of patients was reported as an integer of more than 0 but less than 5, this has been stated as < 5 due to CPRD reporting requirements
**Statistically significant result (α = 0.05)
†Bone fixation procedures were any procedures that involved internal or external bone fixation; for example, fixation related to fracture stabilisation. Bone fixation for limb lengthening was coded under ‘limb lengthening’; however, fractures caused by or associated with limb-lengthening may have been coded under ‘bone fixation’