Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea.
Department of Ophthalmology, Hallym University College of Medicine, Anyang, Republic of Korea.
Sci Rep. 2020 Mar 17;10(1):4891. doi: 10.1038/s41598-020-61805-6.
The influence of visual impairment and blindness on the risk of mortality has been reported in diverse cohort studies. However, the results reported have varied from nonsignificant to significant associations. In the present study, we evaluated the influence of blindness on the risk of mortality from 2002 to 2013 using a longitudinal database with a national sample cohort provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 1,279 subjects who were registered as blind were enrolled, and 5,116 control participants were matched at a 1:4 ratio for age, sex, income, region of residence, and medical histories of hypertension, diabetes mellitus and dyslipidemia. The life/death information contained in this dataset was used for the analysis; this information was originally recorded by the medical doctors on the death certificates of the participants. The percentage of total deaths during the mean follow-up period of 111.0 ± 41.6 months was 28.1% in the blindness group and 19.7% in the matched control group. The risk of mortality was significantly higher in the blindness group than in the control group according to the Cox proportional hazards model with additional adjustments for ischemic heart disease, stroke, and depression (adjusted hazard ratio [HR] of mortality = 1.54, 95% confidence interval [CI] = 1.37-1.74, P < 0.001). In the subgroup analyses, the adjusted HRs for mortality were significantly higher in the blindness group than in the control group regardless of age (young defined as <60 years old vs old defined as ≥60 years old) and sex. The percentage of death due to metabolic diseases and genitourinary diseases was higher in the blindness group than in the matched control group.
视力障碍和失明对死亡率的影响在各种队列研究中都有报道。然而，报告的结果从无显著关联到有显著关联不等。在本研究中，我们使用韩国国家健康保险服务提供的全国样本队列的纵向数据库，评估了失明对 2002 年至 2013 年死亡率风险的影响。在总共 1125691 名受试者中，有 1279 名被登记为失明者入组，按照年龄、性别、收入、居住地区以及高血压、糖尿病和血脂异常的病史，以 1:4 的比例匹配了 5116 名对照参与者。该数据集包含的生命/死亡信息用于分析；这些信息最初是由医生根据参与者的死亡证明记录的。在平均 111.0±41.6 个月的随访期间，总死亡率在失明组为 28.1%，在匹配的对照组为 19.7%。根据 Cox 比例风险模型，在校正缺血性心脏病、中风和抑郁后，失明组的死亡风险明显高于对照组（校正后的死亡率风险比 [HR]为 1.54，95%置信区间 [CI]为 1.37-1.74，P<0.001）。在亚组分析中，无论年龄（<60 岁定义为年轻组，≥60 岁定义为老年组）和性别如何，失明组校正后的死亡率 HR 均明显高于对照组。失明组因代谢性疾病和泌尿生殖系统疾病导致的死亡比例高于对照组。
