Esophageal strictures are a leading cause of dysphagia, but data regarding the epidemiology of esophageal strictures are limited. This study aimed to investigate the prevalence, health care utilization, and financial burden of esophageal strictures in the United States. We performed a retrospective cohort study using 2 large national insurance claims databases (MarketScan and Medicare). Using International Classification of Diseases-9 and -10 diagnostic codes, annual prevalence was calculated for both cohorts overall, and stratified by age and sex strata. Most common diagnostic and procedural codes associated with esophageal strictures were extracted and analyzed to estimate health care utilization. Direct annual medical costs of esophageal strictures were calculated. The annual prevalence of esophageal strictures in MarketScan in 2021 was 203.14 cases/100,000 people, whereas the annual prevalence in Medicare cohort in 2017 was 1123.47 cases/100,000. Although rates were relatively stable over time, esophageal stricture prevalence increased with advancing age. No prevalence differences were noticed between males and females. Gastroesophageal reflux disease/erosive esophagitis was the top diagnostic code associated with esophageal strictures, although an increase in the proportion of eosinophilic esophagitis codes was noted over time. Esophageal dilation codes were present in ∼50% of stricture cases. The total health care costs associated with esophageal strictures were estimated at $1.39 billion in 2017. Esophageal strictures are common, affecting between 1/100 and 1/1000 patients in the United States, with the highest rates seen in patients aged 75 years and older. Accordingly, strictures have a significant financial burden on the health care system, with costs greater than $1 billion annually.

中文翻译：

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美国食管狭窄的患病率和费用

食管狭窄是吞咽困难的主要原因，但有关食管狭窄流行病学的数据有限。本研究旨在调查美国食管狭窄的患病率、医疗保健利用率和经济负担。我们使用 2 个大型国家保险理赔数据库（MarketScan 和 Medicare）进行了一项回顾性队列研究。使用国际疾病分类-9 和-10 诊断代码，计算两个队列的年度患病率，并按年龄和性别分层。提取并分析与食管狭窄相关的最常见的诊断和程序代码，以估计医疗保健利用率。计算了食管狭窄的直接年度医疗费用。 2021 年 MarketScan 中食管狭窄的年患病率为 203.14 例/10 万人，而 2017 年 Medicare 队列中的年患病率为 1123.47 例/10 万人。尽管随着时间的推移，食管狭窄的发生率相对稳定，但食管狭窄的患病率随着年龄的增长而增加。男性和女性之间没有发现患病率差异。胃食管反流病/糜烂性食管炎是与食管狭窄相关的首要诊断代码，尽管随着时间的推移，嗜酸性粒细胞性食管炎代码的比例有所增加。约 50% 的狭窄病例存在食管扩张代码。 2017 年，与食管狭窄相关的总医疗费用估计为 13.9 亿美元。食管狭窄很常见，影响美国 1/100 至 1/1000 的患者，其中 75 岁及以上患者的发病率最高。因此，限制对医疗保健系统造成了巨大的经济负担，每年的费用超过 10 亿美元。