Monz Brigitta, Chartier-Kastler Emmanuel, Hampel Christian, Samsioe Goran, Hunskaar Steinar, Espuna-Pons Montserrat, Wagg Adrian, Quail Deborah, Castro Ramiro, Chinn Chris
Boehringer Ingelheim, Health Economics and Outcomes Research, Ingelheim, Germany.
Eur Urol. 2007 Apr;51(4):1073-81; discussion 1081-2. doi: 10.1016/j.eururo.2006.09.022. Epub 2006 Oct 11.
To investigate the association between patient characteristics and disease-specific and generic quality of life (QOL) as well as the degree of bother in women seeking treatment for urinary incontinence (UI).
The Prospective Urinary Incontinence Research (PURE) was a 6-mo observational study with 1055 physicians from 15 European countries enrolling 9487 women. QOL was assessed at the enrolment visit using the urinary Incontinence Quality of Life questionnaire (I-QOL) and the generic EQ-5D. A single-item instrument was used to measure the degree of bother. UI severity was assessed using the Sandvik Index. UI was categorised into stress (SUI), mixed (MUI), and urge (UUI) urinary incontinence by a patient-administered instrument (Stress and Urge Incontinence Questionnaire [S/UIQ]). Multivariate linear (I-QOL, EQ-5D Visual Analogue Scale) and logistic (bother, EQ-5D health state index) regressions were performed.
Mean total I-QOL scores were significantly and independently associated with UI severity, nocturia, age, UI subtype, number of selected concomitant medical conditions, length of suffering from UI before contacting a doctor, smoking status, ongoing use of UI medication, and country. After adjusting for all the covariates, the total I-QOL scores for SUI, MUI, and UUI were 62.7, 53.8 and 60.1, respectively. As with I-QOL, UI severity was also the most important predictor for bother. The number of concomitant medical conditions, together with UI severity, was the variable most strongly associated with EQ-5D.
In addition to the UI subtypes, severity of UI should be given more importance in treatment algorithms and in treatment decision-making by both the patient and the physician.
探讨寻求尿失禁（UI）治疗的女性患者特征与疾病特异性及一般生活质量（QOL）之间的关联，以及困扰程度。
前瞻性尿失禁研究（PURE）是一项为期6个月的观察性研究，来自15个欧洲国家的1055名医生招募了9487名女性。在入组访视时，使用尿失禁生活质量问卷（I-QOL）和通用的EQ-5D评估生活质量。使用单项工具测量困扰程度。使用桑德维克指数评估UI严重程度。通过患者自行管理的工具（压力性和急迫性尿失禁问卷[S/UIQ]）将UI分为压力性（SUI）、混合性（MUI）和急迫性（UUI）尿失禁。进行多变量线性（I-QOL、EQ-5D视觉模拟量表）和逻辑（困扰、EQ-5D健康状态指数）回归分析。
I-QOL总分均值与UI严重程度、夜尿症、年龄、UI亚型、所选合并症数量、就医前患UI的时长、吸烟状况、正在使用的UI药物以及国家显著且独立相关。在对所有协变量进行调整后，SUI、MUI和UUI的I-QOL总分分别为62.7、53.8和60.1。与I-QOL一样，UI严重程度也是困扰的最重要预测因素。合并症数量与UI严重程度一起，是与EQ-5D关联最强烈的变量。
除了UI亚型外，在治疗方案以及患者和医生的治疗决策中，UI严重程度应得到更多重视。
