The Epidemiology of Pilonidal Disease in Georgia 2020-2022

Abstract

Background: Epidemiological data on pilonidal disease in Georgia are limited, with no available information on the severity of the condition, which plays a key role in treatment decision-making. Objectives: Our research aimed to study the incidence of pilonidal sinus and its characteristics in Georgia from 2020 to 2022. Methods: The incidence of pilonidal sinus (pilonidal cyst) with abscess (ICD code - L05.0) and without abscess (ICD code - L05.9) in the population of both genders across both outpatient and inpatient settings in Georgia from 2020 to 2022 was evaluated using data provided by the National Center for Disease Control and Public Health of Georgia, named after L. Sakvarelidze. Crude incidence rates, age-specific rates according to five-year age groups, and age- standardized rates (ASR) were calculated, along with 95% confidence intervals (95% CI). The null hypothesis was rejected at a p-value <0.05. Results: A total of 4,263 cases of pilonidal cysts (both with and without abscess) were identified in the population of both genders in both outpatient and inpatient settings. The crude rate was 38.2 per 100,000 persons, and the ASR was 46.4 (95% CI: 44.9–47.8). For male patients, the crude rate was 40.8 per 100,000 persons, with an ASR of 75.5 (95% CI: 73.0–78.0), while for female patients, the crude rate was 6.4 per 100,000 persons, with an ASR of 15.6 (95% CI: 13.6–17.6). The male-to-female standardized rate ratio was 4.83 (95% CI: 4.62–5.09). Additionally, new cases of pilonidal disease were more frequently detected in hospitals (ASR = 34.1, 95% CI: 32.1–36.1) compared to outpatient settings (ASR = 12.3, 95% CI: 11.6–13.1), with a standardized rate ratio of 2.8 (95% CI: 2.6–3.0). Conclusions: The incidence of pilonidal sinus in Georgia (crude rate = 38.2 per 100,000; ASR = 46.4 per 100,000) was significantly higher than the global average (26 per 100,000). Furthermore, hospital treatment was nearly three times more frequent than outpatient treatment, which calls for attention from healthcare professionals and policymakers due to potential social and economic implications.