Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
BMJ Open. 2013 Nov 19;3(11):e003297. doi: 10.1136/bmjopen-2013-003297.
To describe the use of symptom-relieving drugs (antimuscarinic drugs or duloxetine) before and after surgery for urinary incontinence (UI); and for those with use of antimuscarinic drugs or duloxetine before surgery, to estimate the risk of being a postoperative user, relative to those without use before surgery.
A historical population-based cohort study.
Denmark.
Women ≥18 years with a first-time surgical procedure for UI from the county of Funen, Denmark between 1 January 1996 and 31 December 2006, extended to the Region of Southern Denmark from 1 January 2007 to the end of 2010. For these women, data on redeemed prescriptions ±365 days of date of surgery were extracted.
Effect of preoperative use of antimuscarinic drugs or duloxetine on the risk of being a postoperative user of these drugs.
Of 2151 women with a first-time surgical procedure for UI, 358 (16.6%) were preoperative users of antimuscarinic drugs or duloxetine and 1793 were not (83.4%). A total of 110 (30.7%) of the preoperative users also redeemed prescriptions for these drugs within 0-60 days after surgery, and 152 (42.5%) of the preoperative users redeemed prescriptions for these drugs within 61-365 days after surgery. Among preoperative non-users, 25 (1.4%) and 145 (8.1%) redeemed prescriptions within 0-60 and 61-365 days after surgery, respectively. Presurgery exposure to antimuscarinic drugs or duloxetine was a strong risk factor of postoperative drug use, both within 0-60 days (adjusted OR=33.0, 95% CI 20.0 to 54.7) and 61-365 days (OR=7.2, 95% CI 5.4 to 9.6).
A substantial number of women will continue to be prescribed symptom-relieving drugs after surgery for UI within a year of follow-up. Only a minority of preoperative non-users initiated usage of symptom-relieving drugs after surgery. Compared with other factors included in the regression model, preoperative use of antimuscarinic drugs or duloxetine was the strongest risk factor for postoperative use.
描述手术前后用于治疗尿失禁（UI）的缓解症状药物（抗毒蕈碱药物或度洛西汀）的使用情况；并对于术前使用抗毒蕈碱药物或度洛西汀的患者，估计其相对于术前未使用者成为术后使用者的风险。
一项基于人群的历史队列研究。
丹麦。
1996 年 1 月 1 日至 2006 年 12 月 31 日期间，丹麦菲英郡首次接受 UI 手术的年龄≥18 岁的女性，2007 年 1 月 1 日至 2010 年底扩大至南丹麦地区。对于这些女性，提取了手术日期前 365 天内和术后 365 天内 redeemed prescriptions± 的数据。
术前使用抗毒蕈碱药物或度洛西汀对成为术后这些药物使用者的风险的影响。
在 2151 名首次接受 UI 手术的女性中，358 名（16.6%）为术前使用抗毒蕈碱药物或度洛西汀者，1793 名（83.4%）为非使用者。共有 110 名（30.7%）术前使用者在术后 0-60 天内也有这些药物的处方，152 名（42.5%）在术后 61-365 天内有这些药物的处方。在术前非使用者中，分别有 25 名（1.4%）和 145 名（8.1%）在术后 0-60 天和 61-365 天内有这些药物的处方。术前接触抗毒蕈碱药物或度洛西汀是术后药物使用的一个强有力的风险因素，无论是在 0-60 天（调整后的 OR=33.0，95%CI 20.0 至 54.7）还是 61-365 天（OR=7.2，95%CI 5.4 至 9.6）。
在术后 1 年的随访中，相当一部分女性在接受 UI 手术后仍将被开具缓解症状的药物。只有少数术前非使用者在手术后开始使用缓解症状的药物。与回归模型中包含的其他因素相比，术前使用抗毒蕈碱药物或度洛西汀是术后使用的最强风险因素。
