Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
The Institute of Urology, Anhui Medical University, Hefei, People's Republic of China.
BMC Urol. 2020 Oct 7;20(1):154. doi: 10.1186/s12894-020-00729-9.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a disease with diverse clinical manifestations, such as pelvic pain or perineal pain. Although recent studies found several risk factors related to the pain severity of CP/CPPS patients, results were inconsistent. Here, we aimed to identify novel risk factors that are closely related to the severity of pain in patients with CP/CPPS.
We retrospectively collected the clinical records from patients with CP/CPPS from March 2019 to October 2019. The questionnaire was used to obtain related parameters, such as demographics, lifestyle, medical history, etc. To identify potential risk factors related to pain severity, we used the methods of univariate and multivariate logistic regression analyses. Further, to confirm the relationship between these confirmed risk factors and CP/CPPS, we randomly divided CP/CPPS patients into the training and the validation cohorts with a ratio of 7:3. According to the co-efficient result of each risk factor calculated by multivariate logistic regression analysis, a predicting model of pain severity was established. The receiver operating characteristic curve (ROC), discrimination plot, calibration plot, and decision curve analyses (DCA) were used to evaluate the clinical usage of the current model in both the training and validation cohorts.
A total of 272 eligible patients were enrolled. The univariate and multivariate logistic regression analysis found that age [odds ratio (OR): 2.828, 95% confidence intervals (CI): 1.239-6.648, P = 0.004], holding back urine (OR: 2.413, 95% CI: 1.213-4.915, P = 0.005), anxiety or irritability (OR: 3.511, 95% CI: 2.034-6.186, P < 0.001), contraception (OR: 2.136, 95% CI:1.161-3.014, P = 0.029), and smoking status (OR: 1.453, 95% CI: 1.313-5.127, P = 0.013) were the risk factors of pain severity. We then established a nomogram model, to test whether these factors could be used to predict the pain severity of CP/CPPS patients in turn. Finally, ROC, DCA, and calibration analyses proved the significance and stability of this nomogram, further confirmed that these factors were closely related to the pain severity of CP/CPPS patients.
We identify age, holding back urine, anxiety or irritability, contraception, and smoking are risk factors closely related to the pain severity in patients with CP/CPPS. Our results provide novel inspirations for clinicians to design the personalized treatment plan for individual CP/CPPS patient who has suffered different encounters.
慢性前列腺炎/慢性骨盆疼痛综合征（CP/CPPS）是一种临床表现多样的疾病，如骨盆疼痛或会阴疼痛。尽管最近的研究发现了一些与 CP/CPPS 患者疼痛严重程度相关的风险因素，但结果并不一致。在这里，我们旨在确定与 CP/CPPS 患者疼痛严重程度密切相关的新的风险因素。
我们回顾性地收集了 2019 年 3 月至 2019 年 10 月期间 CP/CPPS 患者的临床记录。使用问卷获得相关参数，如人口统计学、生活方式、病史等。为了确定与疼痛严重程度相关的潜在风险因素，我们使用了单变量和多变量逻辑回归分析的方法。进一步，为了确认这些已确认的风险因素与 CP/CPPS 之间的关系，我们将 CP/CPPS 患者随机分为训练和验证队列，比例为 7:3。根据多变量逻辑回归分析计算的每个风险因素的系数结果，建立疼痛严重程度的预测模型。使用接收者操作特征曲线（ROC）、判别图、校准图和决策曲线分析（DCA）来评估当前模型在训练和验证队列中的临床应用。
共纳入 272 名符合条件的患者。单变量和多变量逻辑回归分析发现，年龄[比值比（OR）：2.828，95%置信区间（CI）：1.239-6.648，P=0.004]、憋尿（OR：2.413，95%CI：1.213-4.915，P=0.005）、焦虑或易怒（OR：3.511，95%CI：2.034-6.186，P<0.001）、避孕（OR：2.136，95%CI：1.161-3.014，P=0.029）和吸烟状况（OR：1.453，95%CI：1.313-5.127，P=0.013）是疼痛严重程度的风险因素。然后，我们建立了一个列线图模型，以测试这些因素是否可以依次用于预测 CP/CPPS 患者的疼痛严重程度。最后，ROC、DCA 和校准分析证明了该列线图的重要性和稳定性，进一步证实这些因素与 CP/CPPS 患者的疼痛严重程度密切相关。
我们确定年龄、憋尿、焦虑或易怒、避孕和吸烟是与 CP/CPPS 患者疼痛严重程度密切相关的风险因素。我们的研究结果为临床医生为遭受不同遭遇的个体 CP/CPPS 患者设计个性化治疗方案提供了新的启示。
