Kim Yoon Jeon, Lee Ji Sung, Lee Yunhan, Lee Hun, Kim Jae Yong, Tchah Hungwon
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Front Med (Lausanne). 2022 Apr 25;9:851536. doi: 10.3389/fmed.2022.851536. eCollection 2022.
To determine the all-cause and cause-specific mortality in elderly patients with vitreoretinal diseases based on vitrectomy status.
Elderly patients (aged ≥ 60 years) diagnosed with vitreoretinal diseases between 2003 and 2012 using the Korean National Health Insurance Service-Senior cohort (2002-2015) were included in this nationwide population-based retrospective cohort study. The exposure of interest was vitrectomy, and information on mortality from patient inclusion until December 2015 was obtained. Cox regression modeling was used to assess the association between vitrectomy and mortality. An additional subgroup analysis was performed to investigate the effects of the underlying retinal disease characteristics and comorbidities on mortality.
The study cohort included 152,283 patients (3,313 and 148,970 in the vitrectomy and non-vitrectomy groups, respectively). The adjusted model showed vitrectomy was associated with a decreased risk of pulmonary-cause mortality [hazard ratio (HR), 0.51; < 0.001]; however, no association was observed for all-cause mortality (HR, 0.93; = 0.325). Vitrectomy was associated with increased mortality risk (all-cause: HR, 1.26; < 0.001 and vascular causes: HR, 1.41; = 0.003) among patients with retinal vascular diseases and decreased mortality risk (all-cause: HR, 0.64; < 0.001 and pulmonary causes: HR, 0.35; = 0.011) among patients with macular diseases. There were significant interactions between age and vitrectomy with respect to all-cause mortality among patients with either vitreoretinal disease.
In elderly patients with retinal diseases, the vitrectomy group showed the lower mortality from pulmonary causes with no association for all-cause mortality.
根据玻璃体切割术状态确定老年玻璃体视网膜疾病患者的全因死亡率和病因特异性死亡率。
本全国性基于人群的回顾性队列研究纳入了2003年至2012年期间使用韩国国民健康保险服务-老年队列（2002 - 2015年）诊断为玻璃体视网膜疾病的老年患者（年龄≥60岁）。感兴趣的暴露因素是玻璃体切割术，并获取了从患者纳入研究至2015年12月的死亡率信息。采用Cox回归模型评估玻璃体切割术与死亡率之间的关联。进行了额外的亚组分析，以研究潜在视网膜疾病特征和合并症对死亡率的影响。
研究队列包括152,283例患者（玻璃体切割术组和非玻璃体切割术组分别为3,313例和148,970例）。校正模型显示，玻璃体切割术与肺部病因死亡率风险降低相关[风险比（HR），0.51；P < 0.001]；然而，未观察到与全因死亡率的关联（HR，0.93；P = 0.325）。在视网膜血管疾病患者中，玻璃体切割术与死亡率风险增加相关（全因：HR，1.26；P < 0.001；血管病因：HR，1.41；P = 0.003），而在黄斑疾病患者中，玻璃体切割术与死亡率风险降低相关（全因：HR，0.64；P < 0.001；肺部病因：HR，0.35；P = 0.011）。在患有任何一种玻璃体视网膜疾病的患者中，年龄与玻璃体切割术在全因死亡率方面存在显著交互作用。
在老年视网膜疾病患者中，玻璃体切割术组的肺部病因死亡率较低，与全因死亡率无关。
