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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 鍾旭東 | 患有夜尿症之老年男性死亡率-Krimpen 研究之十五年追蹤 | 2012/8/30 上午 09:38:23 | 0 |
| 原 文 | 題 目 | Mortality in Older Men with Nocturia. A 15-year Followup of Krimpen Study |
| 作 者 | Boris van Doorn, Esther T. Kok., Marco H. Blanker, Paul Westers and J. L.H. Ruud Bosch | |
| 出 處 | Journal of Urology ; 187 : 1727-31. | |
| 出版日期 | May, 2012 | |
| 評 論 | 男性夜尿症發生率相當高，尤其在老年男性相當重要也相當擾人及嚴重影響生活品質。 根據台灣的統計與研究也發現在男性下泌尿症狀裡面， 夜尿症往往是最另病人感到不適的症狀及就醫的原因。 當然夜尿症除了影響睡眠品質以外， 也會使得病患之工作能力下降， 精神注意力不集中， 也有較高的機會導致病人併發跌倒及骨折之機會，然而台灣似乎尚未有一項全國性老年男性夜尿症人數推估及後續併發症及死亡率相關性的研究報告。本文為荷蘭之Krimpen地區的十五年長期追蹤老年男性夜尿症的一項長年追蹤性調查，研究結果發現，雖然在單變項分析及Kaplan-Meier 存活分析都發現有夜尿症之五十歲至七十八歲的老年男性有比較高的死亡率 。這篇研究的特別之處在於研究群增加了病人的三天的frequency-volume chart 的資料，進一步區分不同形式的夜尿情況是否會影響死亡率根據此項調查得到的結論是不管是突發性 暫時性 及持續性的夜尿形態，都不會增加男性的死亡率。此項調查可以讓我們參考，年紀似乎比夜尿症對於死亡率的影響更為顯著 。 | |
| abstract |
Purpose: Althoughnocturiaseemstoberelatedtoincreasedmortalityinoldermen, it is unclear whether this is an independent association. Therefore, we studied the association of nocturia and mortality in community dwelling older men. Materials and Methods: A longitudinal, population based study was conducted among 1,688 men 50 to 78 years old. Recruitment started in 1995. At baseline all men completed a questionnaire and a 3-day frequency-volume chart. Nocturnal voiding frequency was derived from the frequency-volume chart and nocturia was defined as 2 or more voids per night. In 2010 all general practitioners’ patient records were checked for possible date of death. Univariable and multivariable Cox regression analyses were performed. A subanalysis was performed to deter- mine the effect of 3 longitudinal nocturia patterns (ie incident, persistent or transient/resolved) on the mortality rate. Results: A total of 1,114 men were eligible for analysis. Median followup was 13.4 years (quartiles 1 to 3: 10.3–14.1) for a total of 12,790 person-years of followup. Univariably nocturia was associated with an increased mortality rate (HR 1.63, 95% CI 1.20 –2.21, p=0.002). After correction for possible confounding factors nocturia had no significant influence on mortality (p=0.838) in contrast to age, chronic obstructive pulmonary disease, smoking and hypertension (all p <0.05). Men with persistent nocturia had the highest mortality rate com- pared to those without nocturia. However, this association was not significant (p =0.083). Conclusions: In an analysis based on frequency-volume chart data, the associa- tion between nocturia and mortality was explained by confounding factors, pre- dominantly age. Furthermore, the mortality risk was not associated with the 3 nocturia patterns. |
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