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间质性膀胱炎/膀胱疼痛综合征患者与随后门诊就诊和住院治疗风险增加相关:一项基于人群的研究。

Interstitial cystitis/bladder pain syndrome patient is associated with subsequent increased risks of outpatient visits and hospitalizations: A population-based study.

机构信息

Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.

Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

PLoS One. 2021 Sep 7;16(9):e0256800. doi: 10.1371/journal.pone.0256800. eCollection 2021.

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is not only a chronic urinary bladder pain syndrome but is also associated with multifactorial etiology. Our study aimed to test the hypothesis that IC/BPS is associated with subsequent increased risks of outpatient visits and hospitalizations. Using nationwide database, the diagnoses were based on the International Classification Codes (ICD-9-CM) (595.1) of at least three outpatient services during 2002-2008, (n = 27,990) and cystoscopic finding Hunner type and/or glomerulation with pre-audit criteria. All recruited cases monitored for subsequent outpatient visits and hospitalizations for 2 years, including all-cause and specialty-specific departments, were classified according to medical specialty and age group (<40, 40-60, ≥60 years of age). IC/BPS patients have more overall outpatient department (OPD) visits and an overall adjusted incidence rate ratio (IRR) of 1.64. As for specialty, IRRs were higher in psychiatry (2.75), Chinese medicine (2.01), and emergency medicine (2.00), besides urology and gynecology. The IRRs decreased as age advanced (2.01, 1.71, and 1.44, respectively), except for gynecology (2.42, 2.52, and 2.81). A similar phenomenon happens in hospitalization with IRR of 1.69. Due to claim data characteristics, whether ulcer type IC/BPS findings can be deductive to non-ulcer type remains inclusive. Current results indicate the impacts of healthcare burden in broad spectrum about IC/PBS patients. IC/BPS has been suggested to be associated with lower threshold of healthcare visits and some coexisting disease and is comprised of systemic dysregulation, and is beyond the scope of local bladder-urethra disease. Adequate recognition of associated or comorbid factors and possible recommendation or referral for IC/BPS patients can help provide better healthcare quality.

摘要

间质性膀胱炎/膀胱疼痛综合征 (IC/BPS) 不仅是一种慢性膀胱疼痛综合征,而且与多因素病因相关。我们的研究旨在检验这样一个假设,即 IC/BPS 与随后门诊就诊和住院治疗的风险增加有关。使用全国性数据库,根据至少三次 2002-2008 年门诊就诊的国际疾病分类代码 (ICD-9-CM) (595.1)(n=27990)和膀胱镜检查发现 Hunner 型和/或肾小球形成,以及预审核标准进行诊断。所有符合条件的病例都在随后的 2 年内进行门诊就诊和住院治疗监测,包括所有原因和专科特定科室,根据医疗专科和年龄组(<40 岁、40-60 岁、≥60 岁)进行分类。IC/BPS 患者的总体门诊就诊次数更多,总体调整后发病率比 (IRR) 为 1.64。就专科而言,精神病科 (2.75)、中医 (2.01) 和急诊医学 (2.00) 的 IRR 较高,除了泌尿科和妇科。随着年龄的增长,IRR 降低(分别为 2.01、1.71 和 1.44),但妇科除外(2.42、2.52 和 2.81)。住院治疗也存在类似现象,IRR 为 1.69。由于索赔数据的特点,是否可以从溃疡性 IC/BPS 发现推断出非溃疡性 IC/BPS 仍有待讨论。目前的结果表明,IC/PBS 患者的医疗保健负担具有广泛的影响。IC/BPS 与较低的医疗保健就诊门槛和一些共存疾病有关,并且包含全身失调,超出了局部膀胱-尿道疾病的范围。充分认识相关或共病因素,并可能为 IC/BPS 患者提供建议或转诊,可以帮助提高医疗保健质量。

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