Okui Nobuo
Urology, Yokosuka Urogynecology and Urology Clinic, Kanagawa, JPN.
Cureus. 2024 Jan 30;16(1):e53245. doi: 10.7759/cureus.53245. eCollection 2024 Jan.
Introduction Discrete mathematics, a branch of mathematics that includes graph theory, combinatorics, and logic, focuses on discrete mathematical structures. Its application in the medical field, particularly in analyzing patterns in patient data and optimizing treatment methods, is invaluable. This study, focusing on post-void residual (PVR) urine following overactive bladder (OAB) treatment, utilized discrete mathematics techniques to analyze PVR and its associated risk factors. Methods A retrospective study was conducted on 128 OAB patients who received intradetrusor onabotulinum toxin A injections between 2020 and 2022. Network graphs based on graph theory were used to analyze correlations between clinical variables, and clustering analysis was performed with PVR as the primary variable. Results The network graph analysis revealed that frailty, daytime frequency, and nocturia episodes were closely related to PVR. Clustering analysis with PVR as the primary variable divided the patients into three groups, suggesting that the group with particularly high frailty (Cluster 1) is at high risk for PVR. Moreover, significant differences in clinical indicators such as age, voiding efficiency, Overactive Bladder Symptom Score, and International Consultation on Incontinence Questionnaire-Short Form were observed in the remaining two clusters (Cluster 0 and 2). Conclusion This study demonstrates the effectiveness of discrete mathematics methods in identifying risk factors for PVR after OAB treatment and in distinguishing clinical subgroups based on patient characteristics. This approach could contribute to the formulation of individualized treatment strategies and the improvement of patient care quality. Further development and clinical application of this methodology are expected in future research.
引言 离散数学是数学的一个分支,包括图论、组合数学和逻辑学,专注于离散数学结构。它在医学领域的应用,特别是在分析患者数据模式和优化治疗方法方面,具有不可估量的价值。本研究聚焦于膀胱过度活动症(OAB)治疗后的残余尿量(PVR),运用离散数学技术分析PVR及其相关危险因素。
方法 对2020年至2022年间接受膀胱逼尿肌内注射A型肉毒杆菌毒素的128例OAB患者进行回顾性研究。基于图论的网络图用于分析临床变量之间的相关性,并以PVR作为主要变量进行聚类分析。
结果 网络图分析显示,虚弱、日间排尿频率和夜尿次数与PVR密切相关。以PVR作为主要变量的聚类分析将患者分为三组,提示虚弱程度特别高的组(第1组)发生PVR的风险较高。此外,在其余两组(第0组和第2组)中,观察到年龄、排尿效率、膀胱过度活动症症状评分和国际尿失禁咨询问卷简表等临床指标存在显著差异。
结论 本研究证明了离散数学方法在识别OAB治疗后PVR的危险因素以及根据患者特征区分临床亚组方面的有效性。这种方法有助于制定个性化治疗策略并提高患者护理质量。预计该方法在未来研究中将得到进一步发展和临床应用。