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青少年及成人遗尿症患者适应性临床干床训练阳性结果的预测因素

Predictors for a positive outcome of adapted clinical dry bed training in adolescents and adults with enuresis.

作者信息

Hofmeester Ilse, Kollen Boudewijn J, Steffens Martijn G, van Capelle Jan Willem, Mulder Zwaan, Feitz Wouter F J, Blanker Marco H

机构信息

Department of Urology, Isala klinieken, Zwolle, Netherlands.

Dry Bed Center, Noorderboog hospital, Meppel, Netherlands.

出版信息

Neurourol Urodyn. 2016 Nov;35(8):1006-1010. doi: 10.1002/nau.22869. Epub 2015 Sep 9.

Abstract

AIMS

Adapted Dry Bed Training (Adapted DBT) has been shown to be effective in therapy-resistant adolescents and adults with enuresis. Given the substantial impact of enuresis and the time-consuming nature of Adapted DBT, we investigated which patients benefited most from Adapted DBT. Therefore, we identified predictors for a successful treatment response to Adapted DBT in this population.

METHODS

Retrospective cohort study in 907 consecutive patients, aged 11-42 years, subjected to in-hospital Adapted DBT in our Dry Bed Center between January 2003 and July 2013. Outcome was defined as treatment success after six months (primary outcome) and six weeks. Results of logistic regression analyses are presented in odds ratios and 95% confidence intervals.

RESULTS

Predictors for a successful treatment response to Adapted DBT in adolescents and adults with enuresis after six months are: gender (female), initial degree of enuresis (mild: 0-3 nights/week), current diaper use, never used anticholinergics in the past, and degree of enuresis six weeks after training. Predictors for successful treatment response after six weeks are: gender and initial degree of enuresis only.

LIMITATION

The low explained variance of our model, showing that many other factors, not included in our study, could be of interest in the prediction of success.

CONCLUSIONS

Several factors that predicted a successful treatment response of Adapted DBT after six weeks and six months were identified. However, the low explained variance of our model suggests that other non-identified factors are also important in predicting outcome. Neurourol. Urodynam. 35:1006-1010, 2016. © 2015 Wiley Periodicals, Inc.

摘要

目的

改良干床训练(Adapted DBT)已被证明对难治性青少年及成人遗尿症有效。鉴于遗尿症的重大影响以及改良干床训练耗时的特性,我们研究了哪些患者能从改良干床训练中获益最多。因此,我们确定了该人群中改良干床训练成功治疗反应的预测因素。

方法

对2003年1月至2013年7月期间在我们干床中心接受住院改良干床训练的907例年龄在11 - 42岁的连续患者进行回顾性队列研究。结局定义为六个月(主要结局)和六周后的治疗成功。逻辑回归分析结果以比值比和95%置信区间呈现。

结果

青少年及成人遗尿症患者六个月后改良干床训练成功治疗反应的预测因素为:性别(女性)、初始遗尿程度(轻度:每周0 - 3晚)、当前使用尿布情况、过去从未使用过抗胆碱能药物以及训练六周后的遗尿程度。六周后成功治疗反应的预测因素仅为:性别和初始遗尿程度。

局限性

我们模型的可解释方差较低,表明许多未纳入本研究的其他因素可能对成功预测有意义。

结论

确定了几个在六周和六个月后预测改良干床训练成功治疗反应的因素。然而,我们模型的低可解释方差表明其他未确定的因素在预测结局方面也很重要。《神经泌尿学与尿动力学》35:1006 - 1010, 2016。© 2015威利期刊公司

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