Ninn-Pedersen K, Stenevi U
Department of Ophthalmology, Lund University Hospital, Sweden.
Br J Ophthalmol. 1995 Dec;79(12):1115-9. doi: 10.1136/bjo.79.12.1115.
Cataract surgery has at times been said to correlate with an increased death risk. We have therefore analysed the standardised death ratio in a population based cohort of patients that had undergone cataract surgery.
Data for all patients undergoing cataract surgery from 1986 up to and including 1990 in the Lund Health Care District were prospectively recorded, and 5120 were retrieved for analysis. Death dates and primary death diagnoses for each patient were obtained from the Swedish Bureau of Census up to and including 1991. Standardised mortality ratios were calculated for all patients, subdivided into a number of categories: inpatients, outpatients, sex, age < 75 years, age > or = 75 years, patients with heart and circulatory diseases, with malignant tumours, and with diabetes. The cut off age was set at 74 because this divided the patients into two approximately equal groups. Using time dependent survival regression, the relative risk for dying were estimated for sex, age, and for postoperative YAG laser capsulotomy, and also for diabetic patients and patients with rheumatoid arthritis.
Inpatients almost always show an increased standardised mortality ratio compared with outpatients. Young patients and diabetic patients also showed an increased standardised mortality ratio, compared with the normal population, but not older patients, who constitute the majority. Cardiovascular death diagnoses were overrepresented among the young.
Cataract surgery is correlated with an increased standardised mortality ratio only in young patients and in patients with certain complicating diseases like diabetes and cardiovascular diseases.
白内障手术有时被认为与死亡风险增加相关。因此,我们分析了一组接受白内障手术的人群队列中的标准化死亡比率。
前瞻性记录了1986年至1990年(含)在隆德医疗保健区接受白内障手术的所有患者的数据,共检索到5120例用于分析。每位患者的死亡日期和主要死亡诊断信息来自瑞典人口普查局,截至1991年(含)。计算了所有患者的标准化死亡率,并细分为多个类别:住院患者、门诊患者、性别、年龄<75岁、年龄≥75岁、患有心脏和循环系统疾病的患者、患有恶性肿瘤的患者以及患有糖尿病的患者。截止年龄设定为74岁,因为这样可将患者大致分为两组。使用时间依赖性生存回归分析,估计了性别、年龄、术后YAG激光晶状体囊切开术、糖尿病患者以及类风湿关节炎患者的死亡相对风险。
与门诊患者相比,住院患者的标准化死亡率几乎总是更高。与正常人群相比,年轻患者和糖尿病患者的标准化死亡率也更高,但占大多数的老年患者并非如此。年轻人中心血管疾病死亡诊断的比例过高。
白内障手术仅在年轻患者以及患有某些并发症(如糖尿病和心血管疾病)的患者中与标准化死亡率增加相关。