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首页> 外文期刊>Mayo Clinic Proceedings: Innovations, Quality & Outcomes >Monoclonal Gammopathy of Undetermined Significance
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Monoclonal Gammopathy of Undetermined Significance

机译：意义未定的单克隆丙种球蛋白病

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Objective: To determine follow-up practice patterns of US patients with monoclonal gammopathy of undetermined significance (MGUS) and their concordance with 4 clinical practice guidelines. Patients and Methods: In a retrospective analysis of adult patients using the OptumLabs Data Warehouse database, we identified those who had an incident diagnosis of MGUS from January 1, 2006, through December 31, 2013, no history or subsequent diagnosis of lymphoplasmacytic malignancy, and at least 2 years of follow-up. Results: A total of 11,676 patients with MGUS were included in the study. During the first 2 years after MGUS diagnosis, the distribution of patients by mean interval between visits was as follows: less than 6 months, 12.7%; every 6 to 12 months, 25.2%; every 13 to 24 months, 17.7%; and longer than 24 months, 44.4%. A higher proportion of patients were followed up at intervals of less than 13 months over time, from 32.7% to 41.1% (P<.001). Patients 60 years or older were more likely to be followed up at intervals of less than 13 months; those from the Northeast or younger than 50 years were more likely to be followed up at intervals longer than 24 months compared with their counterparts (P<.001). More than half of the patients 80 years or older were followed up at intervals of less than 6 months (12.3%), 6 to 12 months (27.8%), or 13 to 24 months (18.2%). Only approximately half of the patients (41.1%-58.8%) with MGUS diagnosed in 2013 were concordant with any of the 4 clinical guidelines. Conclusion: The MGUS follow-up practice patterns varied geographically and demographically and were frequently discordant with guideline recommendations. A large proportion of patients with limited life expectancy had frequent follow-up visits.
机译：目的：确定具有重要意义的美国未确诊单克隆丙种球蛋白病（MGUS）的随访实践模式，并确定其与4项临床实践指南的一致性。患者和方法：在使用OptumLabs数据仓库数据库对成年患者进行的回顾性分析中，我们确定了从2006年1月1日至2013年12月31日发生MGUS事件诊断，无淋巴浆细胞性恶性肿瘤病史或随后诊断的患者，以及至少2年的随访。结果：总共11,676例MGUS患者被纳入研究。在MGUS诊断后的前2年中，按两次就诊之间的平均间隔进行的患者分布如下：少于6个月，占12.7％;平均随访时间少于7个月。每6至12个月，占25.2％;每13至24个月，占17.7％;超过24个月的占44.4％。随着时间的流逝，随访时间少于13个月的患者比例更高，从32.7％降至41.1％（P <.001）。 60岁或60岁以上的患者更有可能在不到13个月的间隔内接受随访;与东北地区相比，东北地区或50岁以下人群的随访时间要长于24个月（P <.001）。 80岁或以上的患者中，超过一半的患者接受随访的时间少于6个月（12.3％），6到12个月（27.8％）或13到24个月（18.2％）。在2013年诊断出的MGUS患者中，只有大约一半的患者（41.1％-58.8％）符合4项临床指南中的任何一项。结论：MGUS的随访实践模式在地理位置和人口统计学上各不相同，并且经常与指导性建议不一致。预期寿命有限的患者中有很大一部分进行了频繁的随访。

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