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美国成年人尿失禁与死亡风险的相关性:一项前瞻性队列研究。

Association between urinary incontinence and mortality risk among US adults: a prospective cohort study.

机构信息

Department of Nursing, Shenzhen Hospital, Southern Medical University, Number 1333, Xinhu Road, Baoán District, Shenzhen, Guangdong, 518101, China.

School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, China.

出版信息

BMC Public Health. 2024 Oct 9;24(1):2753. doi: 10.1186/s12889-024-20091-x.

Abstract

BACKGROUND

Urinary incontinence is frequent in the general population and affects men and women of all ages. UI carries an unsuspected load on the healthcare system. To investigate whether urinary incontinence is associated with all-cause, cardiovascular disease (CVD) and cancer mortality among US adults.

METHODS

The analyzed data was collected from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) data. A total of 25,182 US participants with complete information about follow-up information and urinary incontinence (UI) were included in this cohort study. Univariate Cox regression analyses, the UpSet plot, multivariate Cox regression analysis, subgroup analysis of all-cause mortality, and Kaplan-Meier survival curve were employed to support the research objectives.

RESULTS

A total of 25,182 participants had a mean age of 49.8 ± 17.8 years, with 49.3% of them being male and 50.7% of them being female. In the unadjusted model, we found that the risk of all-cause mortality increased by 12% (95% CI 1.03-1.22, P = 0.008), the risk of CVD mortality increased by 21% (95% CI 1.07-1.36, P = 0.002), and the risk of Cancer mortality increased by 8% (95% CI 0.95-1.22, P = 0.243) among individuals with urinary incontinence. After adjusting for multiple variables, we found that the risk of all-cause mortality in patients with urinary incontinence decreased by 1% (95% CI 0.9-1.09), but this decrease was statistically insignificant (P = 0.868), and the risk of Cancer mortality decreased by 3% (95% CI 0.84-1.12, P = 0.686). The association between urinary incontinence and mortality risk were stable in stratified analyses.

CONCLUSIONS

In our study, we found that urinary incontinence itself is an independent risk factor for death. The association between urinary incontinence and mortality became less significant after adjusting for covariates, this is a common occurrence in statistical analysis. Future research, with larger sample sizes and more robust study designs, is needed to further elucidate the complex relationship between urinary incontinence and mortality risk.

摘要

背景

尿失禁在普通人群中很常见,影响着各个年龄段的男性和女性。尿失禁给医疗保健系统带来了意想不到的负担。本研究旨在探讨尿失禁是否与美国成年人的全因、心血管疾病(CVD)和癌症死亡率相关。

方法

本分析数据来自 2007-2016 年全国健康和营养检查调查(NHANES)数据。共有 25182 名美国参与者,他们的随访信息和尿失禁(UI)信息完整,纳入本队列研究。采用单变量 Cox 回归分析、UpSet 图、多变量 Cox 回归分析、全因死亡率亚组分析和 Kaplan-Meier 生存曲线来支持研究目标。

结果

共有 25182 名参与者的平均年龄为 49.8±17.8 岁,其中 49.3%为男性,50.7%为女性。在未调整模型中,我们发现全因死亡率的风险增加了 12%(95%CI 1.03-1.22,P=0.008),CVD 死亡率的风险增加了 21%(95%CI 1.07-1.36,P=0.002),癌症死亡率的风险增加了 8%(95%CI 0.95-1.22,P=0.243)。在调整了多个变量后,我们发现尿失禁患者的全因死亡率风险降低了 1%(95%CI 0.9-1.09),但这一降低无统计学意义(P=0.868),癌症死亡率风险降低了 3%(95%CI 0.84-1.12,P=0.686)。分层分析表明,尿失禁与死亡风险之间的关联是稳定的。

结论

在本研究中,我们发现尿失禁本身是死亡的独立危险因素。在调整了协变量后,尿失禁与死亡率之间的关联变得不那么显著,这在统计学分析中很常见。未来需要更大样本量和更稳健研究设计的研究来进一步阐明尿失禁与死亡风险之间的复杂关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f687/11463129/6cb79b1eecb1/12889_2024_20091_Fig1_HTML.jpg

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