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帕金森病与女性死亡风险的前瞻性共病匹配研究。

Prospective comorbidity-matched study of Parkinson's disease and risk of mortality among women.

作者信息

Winter Anke C, Rist Pamela M, Buring Julie E, Kurth Tobias

机构信息

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

BMJ Open. 2016 Sep 26;6(9):e011888. doi: 10.1136/bmjopen-2016-011888.

Abstract

BACKGROUND

Individuals with Parkinson's disease (PD) may have an increased risk of overall mortality compared to the general population. Women may have lower mortality rates from PD than men; however, studies among women on the effect of PD on mortality have been limited and may not have adequately controlled for confounding by comorbidities.

METHODS

We conducted a matched cohort study among participants in the Women's Health Study. 396 incident PD cases were identified through self-report. Each PD case was matched by age to a comparator who was alive and had the same modified Charlson comorbidity score as the PD case. The PD cases and matched comparators were followed for all-cause mortality. Cox proportional hazards models adjusted for age at the index date, smoking, alcohol consumption, exercise and body mass index were used to determine the association between PD and mortality.

RESULTS

During a median of 6.2 years of follow-up, 72 women died (47 PD cases and 25 comparators). The multivariable-adjusted HR for mortality was 2.60 (95% CI 1.56 to 4.32).

CONCLUSIONS

PD was associated with more than a twofold increased risk of all-cause mortality among women. Results are similar to those observed among men.

摘要

背景

与普通人群相比,帕金森病(PD)患者的全因死亡率可能更高。女性PD患者的死亡率可能低于男性;然而,关于PD对女性死亡率影响的研究有限,且可能未充分控制合并症造成的混杂因素。

方法

我们在女性健康研究的参与者中进行了一项匹配队列研究。通过自我报告确定了396例新发PD病例。每例PD病例按年龄与一名存活且与PD病例具有相同修正查尔森合并症评分的对照者进行匹配。对PD病例和匹配的对照者进行全因死亡率随访。使用校正了索引日期时的年龄、吸烟、饮酒、运动和体重指数的Cox比例风险模型来确定PD与死亡率之间的关联。

结果

在中位6.2年的随访期间,72名女性死亡(47例PD病例和25名对照者)。多变量调整后的死亡风险比为2.60(95%置信区间1.56至4.32)。

结论

PD与女性全因死亡率增加两倍以上相关。结果与在男性中观察到的相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/854f/5051400/cea356333c1b/bmjopen2016011888f01.jpg

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