Supplementary Material for: Odds of Medical Comorbidities in Essential Tremor: Retrospective Analysis of a Large Claims Database in the United States

Introduction: Essential tremor (ET) is the most common tremor disorder, estimated to affect 7 million individuals in the U.S. There is little empirical evidence on comorbidities among this population beyond higher prevalence of brain-related and stress-related disorders. This study aims to examine differences in the prevalence of the 31 Elixhauser comorbidities among ET patients compared to statistically similar control patients. Methods: An extract from Optum’s de-identified Clinformatics® Data Mart Database (CDM) from 2018-2019 of adults aged 40 to 80 years with at least one claim with an ET diagnosis was propensity score matched to controls. Logistic regression was used to generate doubly robust adjusted odds ratios for each of the 31 Elixhauser comorbidities. Results: In these analyses, ET patients had significantly greater adjusted odds of depression, alcohol abuse, and other neurological disorders, as well as chronic pulmonary disease, renal failure, hyperthyroidism, and cardiac arrhythmias relative to controls. They also had lower odds of uncomplicated diabetes, congestive heart failure, metastatic cancer, paralysis, peripheral vascular disease, and fluid and electrolyte disorders. Conclusion: A number of recent studies, including our own, suggest that psychiatric, neurologic and stress-related disorders may be more prevalent among ET patients than controls. Additional differences in the prevalence of a range of medical comorbidities have also been variably reported across studies, suggesting that some combination of these might be more prevalent. Further studies would be of value in sorting through these associations.

引言：原发性震颤（Essential tremor, ET）是最为常见的震颤障碍性疾病，据估算在美国有700万人群受其影响。目前针对该人群共病状况的实证研究较为匮乏，仅明确其脑部相关及应激相关障碍的患病率更高。本研究旨在对比原发性震颤患者与统计学特征匹配的对照患者之间，31种Elixhauser共病（Elixhauser comorbidities）的患病率差异。
方法：本研究数据提取自2018-2019年Optum旗下去标识化的Clinformatics®数据集市数据库（Clinformatics® Data Mart Database, CDM），研究对象为年龄40至80岁、至少存在1次原发性震颤诊断记录的成年患者，通过倾向得分匹配法匹配对照人群。随后采用Logistic回归分析，针对31种Elixhauser共病分别计算双重稳健校正比值比。
结果：本次分析显示，相较于对照人群，原发性震颤患者的校正后患病比值比显著升高的共病包括：抑郁症、酒精滥用、其他神经系统疾病，以及慢性肺部疾病、肾衰竭、甲状腺功能亢进症与心律失常。同时，原发性震颤患者的以下共病患病率显著更低：无并发症糖尿病、充血性心力衰竭、转移性癌症、瘫痪、外周血管疾病以及体液与电解质紊乱。
结论：近期多项研究（包括本团队的研究）均表明，原发性震颤患者的精神类、神经类及应激相关障碍患病率高于对照人群。不同研究中还陆续报道了一系列其他医学共病的患病率差异，提示上述部分共病的患病率可能确实更高。未来开展进一步研究以厘清这些关联具有重要价值。