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多发性硬化症与近 9000 例患者随访长达 10 年的尿失禁和粪便失禁发生率。

Multiple Sclerosis and Incidence of Urinary and Fecal Incontinence in Almost 9,000 Patients Followed Up for up to 10 Years in Germany.

机构信息

Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.

Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.

出版信息

Neuroepidemiology. 2021;55(2):92-99. doi: 10.1159/000513234. Epub 2021 Mar 4.

Abstract

BACKGROUND

There is a lack of large studies on urinary (UI) and fecal incontinence (FI) following multiple sclerosis (MS) diagnosis. Thus, our goal was to investigate the association between MS and the incidence of UI and FI in patients followed up for up to 10 years in Germany.

METHODS

This study included patients who received an initial documentation of MS diagnosis in general practices in Germany during 2005-2018 (index date). Patients without MS were matched (1:1) to those with MS using propensity scores based on sex, age, index year, follow-up time (in years), general practice, and the Charlson Comorbidity Index score (index date: a randomly selected visit date).

RESULTS

This retrospective study included 4,461 patients with MS and 4,461 patients without MS (69.9% women; mean [SD] age 44.2 [12.7] years). Within 10 years of index date, a higher proportion of patients with MS were diagnosed with UI (11.7 vs. 3.2%) and FI (2.3 vs. 0.5%; p values <0.001) than those without MS. MS was further found to be associated with both UI (hazard ratio [HR] = 3.85) and FI (HR = 5.38; p values <0.001) in the Cox regressions.

CONCLUSIONS

UI and FI are frequent complications of MS, and the presence of these complications should be regularly assessed in primary care practices.

摘要

背景

多发性硬化症(MS)确诊后,关于尿失禁(UI)和粪便失禁(FI)的大型研究较少。因此,我们的目标是在德国对多达 10 年的患者进行随访,调查 MS 与 UI 和 FI 发病之间的关系。

方法

本研究纳入了 2005 年至 2018 年期间德国普通诊所首次确诊 MS 的患者(索引日期)。根据性别、年龄、索引年、随访时间(年)、普通诊所和 Charlson 合并症指数评分(索引日期:随机选择的就诊日期),对无 MS 患者进行倾向评分匹配(1:1)。

结果

这项回顾性研究纳入了 4461 例 MS 患者和 4461 例无 MS 患者(女性占 69.9%;平均[SD]年龄 44.2[12.7]岁)。在索引日期后的 10 年内,MS 患者被诊断为 UI(11.7% vs. 3.2%)和 FI(2.3% vs. 0.5%;p 值均<0.001)的比例高于无 MS 患者。Cox 回归分析进一步显示,MS 与 UI(HR=3.85)和 FI(HR=5.38;p 值均<0.001)均相关。

结论

UI 和 FI 是 MS 的常见并发症,初级保健实践中应定期评估这些并发症的存在情况。

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