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在一个种族和民族多样化的人群中,压力性尿失禁女性的患病率、风险因素和治疗。

Prevalence, risk factors, and treatment for women with stress urinary incontinence in a racially and ethnically diverse population.

机构信息

Yeshiva University Albert Einstein College of Medicine, Bronx, New York.

Department of Urology, Montefiore Hospital and Medical Center, Bronx, New York.

出版信息

Neurourol Urodyn. 2019 Mar;38(3):934-940. doi: 10.1002/nau.23930. Epub 2019 Jan 28.

Abstract

AIMS

Black women may have lower rates of SUI than Whites, whereas the rate of SUI in Hispanic women varies. Most studies have been conducted in predominantly White populations, making it difficult to evaluate race and SUI. The objective of this study was to estimate the prevalence of SUI in a diverse population and examine racial/ethnic differences in risk factors and treatment.

METHODS

This is a retrospective cohort study of women ≥21 years with SUI seen at our medical center from June 1, 2013 to June 30, 2016. Risk factors measured included age, BMI, SES, diabetes, smoking, Charlson comorbidity index, hysterectomy, and pregnancy. SUI management included consultation with a specialist and active treatment (physical therapy, pessary use, or incontinence surgery). ANOVA, chi-square, and multivariable logistic regression were used to evaluate race and SUI.

RESULTS

The prevalence rate was 4.65 per 100 women (5557 cases/119 452 women). Hispanics comprised the majority (54.13% n = 3008), followed by Blacks (23.54% n = 1308), Other (12.74% n = 708), and Whites (9.59% n = 532). Black women were less likely to consult with a specialist or undergo treatment compared to White and Hispanic women, which persisted in multivariable analysis. Women classified as other were more likely to undergo active treatment in the logistic regression model.

CONCLUSION

SUI prevalence was highest in Hispanics, despite risk factors being more common in Black women. Black women were less likely to consult with a specialist. Mixed or unknown race/ethnicity women were more likely to undergo active treatment. Future studies will evaluate if racial/ethnic differences in SUI management are due to patient preference or provider practices.

摘要

目的

黑人女性的 SUI 发病率可能低于白人,而西班牙裔女性的 SUI 发病率则有所不同。大多数研究都是在以白种人为主的人群中进行的,因此很难评估种族和 SUI 之间的关系。本研究的目的是评估在不同人群中 SUI 的患病率,并研究种族/民族差异在危险因素和治疗中的作用。

方法

这是一项回顾性队列研究,纳入了 2013 年 6 月 1 日至 2016 年 6 月 30 日期间在我们医疗中心就诊的年龄≥21 岁的 SUI 女性患者。测量的危险因素包括年龄、BMI、社会经济地位、糖尿病、吸烟、Charlson 合并症指数、子宫切除术和妊娠。SUI 的治疗方法包括咨询专家和积极治疗(物理治疗、使用子宫托或尿失禁手术)。采用方差分析、卡方检验和多变量逻辑回归评估种族和 SUI 之间的关系。

结果

SUI 的患病率为每 100 名女性 4.65 例(5557 例/119452 名女性)。西班牙裔患者占大多数(54.13%,n=3008),其次是黑人(23.54%,n=1308)、其他(12.74%,n=708)和白人(9.59%,n=532)。与白人及西班牙裔女性相比,黑人女性更倾向于不咨询专家或接受治疗,多变量分析结果仍一致。在逻辑回归模型中,其他种族/民族的女性更倾向于接受积极治疗。

结论

尽管黑人女性的危险因素更为常见,但西班牙裔患者的 SUI 患病率最高。黑人女性更倾向于不咨询专家。混合或未知种族/民族的女性更倾向于接受积极治疗。未来的研究将评估 SUI 管理中的种族/民族差异是否是由于患者的偏好还是医生的治疗实践所致。

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