School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong.
Qual Life Res. 2021 May;30(5):1305-1315. doi: 10.1007/s11136-020-02731-y. Epub 2021 Jan 14.
No previous study has used a data-driven approach to explore symptom subclasses among patients with lower urinary tract symptoms (LUTS). The objectives of this study were to use latent class analysis (LCA) to identify distinct classes of LUTS among primary care patients and to assess the class differences in health-related quality of life (HRQOL).
In this cross-sectional study, 500 patients were randomly recruited, and 18 symptoms according to the International Continence Society 2002 criteria were assessed. Classes were identified by LCA. Patient HRQOL was measured using the 12-item Short Form Health Survey (version 2), the modified Incontinence Impact Questionnaire-Short Form and the HRQOL item from the International Prostate Symptom Score.
Six distinct LUTS classes were identified: "asymptomatic" (26.0%), "mild symptoms" (22.6%), "moderate multiple symptoms" (17.0%), "urgency symptoms" (13.8%), "urinary incontinence" (12.0%) and "severe multiple symptoms" (8.6%). Multinomial regression analysis found differences in the gender distribution and prevalence of heart diseases across classes, and multiple linear regression found that patients with "severe multiple symptoms" and "urinary incontinence" had the poorest HRQOL.
Almost three quarters of the primary care patients in this study were suffering from varying degrees of LUTS. The poor HRQOL in "severe multiple symptoms" and "urinary incontinence" implies that patients in these classes require additional attention and treatments.
先前的研究尚未采用数据驱动的方法来探索下尿路症状(LUTS)患者的症状亚型。本研究的目的是使用潜在类别分析(LCA)来确定初级保健患者中不同的 LUTS 类别,并评估健康相关生活质量(HRQOL)的类别差异。
在这项横断面研究中,随机招募了 500 名患者,并根据国际尿控协会 2002 年的标准评估了 18 种症状。通过 LCA 确定类别。使用 12 项简短健康调查(第 2 版)、改良尿失禁影响问卷-简短版和国际前列腺症状评分中的 HRQOL 项目来衡量患者的 HRQOL。
确定了六个不同的 LUTS 类别:“无症状”(26.0%)、“轻度症状”(22.6%)、“中度多种症状”(17.0%)、“急迫症状”(13.8%)、“尿失禁”(12.0%)和“重度多种症状”(8.6%)。多项分类回归分析发现,各类别之间的性别分布和心脏病患病率存在差异,多元线性回归发现,患有“重度多种症状”和“尿失禁”的患者 HRQOL 最差。
本研究中近四分之三的初级保健患者患有不同程度的 LUTS。“重度多种症状”和“尿失禁”患者的 HRQOL 较差,这意味着这些类别的患者需要额外的关注和治疗。