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. 2021 Sep 1;87(3):265-270.
doi: 10.1097/SAP.0000000000002734.

Temporal Trends and Geographical Variation in Dupuytren Disease Surgery in England: A Population-Based Cohort Study

Osaid Alser  1 , Simon G F Abram  1 , Richard S Craig  1 , Jennifer C E Lane  1 , Abigail V Shaw  2 , Albert Prats-Uribe  1 , Jonathan L Rees  1 , Daniel Prieto-Alhambra  1 , Dominic Furniss
Affiliations

Temporal Trends and Geographical Variation in Dupuytren Disease Surgery in England: A Population-Based Cohort Study

Osaid Alser et al. Ann Plast Surg. .

Abstract

Background: Dupuytren disease (DD) is a common fibroproliferative disease of the palmar fascia. The mainstay of DD treatment in England is surgery with either percutaneous needle fasciotomy, limited fasciectomy, or dermofasciectomy. This study aimed to investigate the temporal trends and geographical variation of primary DD surgery in England.

Methods: A longitudinal population-based cohort study was perfomed using the Hospital Episode Statistics database from April 1, 2007, to March 31, 2017. Directly standarized rates were estimated over time (between financial years 2007-2008 and 2016-2017) and by geographic region (by clinical commissioning groups [CCGs]; financial years 2010-2011, 2013-2014, and 2016-2017). The Office for National Statistics midyear population estimates were used as the reference population.

Main findings: Primary DD surgery was undertaken at a steadily increasing rate from financial year 2007 to 2008, to 2016 to 2017 in England. There was a striking 3.6-fold variation in the rates of primary DD surgery among National Health Service CCGs in England place of residence.

Conclusions: This significant variation in DD surgical treatment in England suggests a need for the development of standardized surgical practice across all CCGs and National Health Service hospitals, promoting equality of access to cost-effective health care.

Trial registration: ClinicalTrials.gov NCT03573765.

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Conflict of interest statement

Conflicts of interest and sources of funding: There are no conflicting interests with respect to the research, authorship, and/or publication of this article except D.P.-A reports grants and other from AMGEN; grants, nonfinancial support, and other from UCB Biopharma; grants from Les Laboratoires Servier, outside the submitted work; and Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums, and Synapse Management Partners have supported training programs organized by D.P.-A's department and open for external participants. O.A. is funded by the Oxford Centre for Islamic Studies Scholarship. S.G.F.A. is funded by the Oxford National Institute of Health Research-Biomedical Research Centre (NIHR-BRC). R.S.C. was a funded Royal College of Surgeons England/National Joint Registry research fellow and is also funded by the NIHR-BRC. J.C.E.L. is a clinical research fellow funded by Versus Arthritis and the Oxford Medical Research Council Doctoral Training Partnership. A.P.-U. is funded by Fundacion Alfonso Martin Escudero and by the Medical Research Council (grant numbers, MR/K501256/1 and MR/N013468/1). J.L.R. is funded by the Oxford NIHR BRC. D.P.-A. is an NIHR Clinician Scientist (project number, CS-2013-13-012). D.F. is funded by the Oxford NIHR-BRC. Funding bodies had no role in study design, data collection, data analysis, data interpretation, or article preparation. The views expressed are those of the authors and not necessarily those of any of the funding bodies.

References

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