Gallstone disease is associated with increased mortality in the United States.
Gallstone disease is associated with increased mortality in the United States.
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DOI：
10.1053/j.gastro.2010.10.060
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发表时间：
2011-02
期刊：
影响因子：
29.4
通讯作者：
Everhart JE
中科院分区：
文献类型：
--
作者：
Ruhl CE;Everhart JE
胆结石是常见的，并有助于发病率和保健费用，但其对死亡率的影响尚不清楚。我们在一个前瞻性的全国人群样本中研究了胆结石病是否与总体死亡率和病因特异性死亡率相关。我们分析了1988年至1994年第三次美国国家健康和营养检查调查（20-74岁）中接受胆囊超声检查的14，228名参与者的数据。胆结石疾病定义为超声记录的胆结石或胆囊切除术的证据。从2006年收集的死亡证明中确定了死亡的根本原因（平均随访时间=14.3年）。采用考克斯比例风险回归分析计算死亡率风险比（HR），以校正多种人口统计学和心血管疾病风险因素。胆囊结石的患病率为7.1%，胆囊切除术的患病率为5.3%。在18年或更长的随访期间，所有原因的累积死亡率为16.5%（2，389例死亡），心血管疾病为6.7%（886例死亡），癌症为4.9%（651例死亡）。在年龄校正分析（HR，1.3; 95%置信区间[CI]，1.2-1.5）和多变量校正分析（HR，1.3; 95% CI，1.1-1.5）中，胆石病患者的全因死亡率较高。心血管疾病死亡率（多变量校正HR，1.4; 95% CI，1.2-1.7）和癌症死亡率（多变量校正HR，1.3; 95% CI，0.98-1.8）也出现类似的增加。胆结石患者的死亡风险增加与胆囊切除术患者相似（多变量校正HR，1.1; 95% CI，0.92-1.4）。在美国人口中，胆石病患者的总体死亡率以及心血管疾病和癌症的死亡率增加。超声诊断的胆囊结石和胆囊切除术都发现了这种关系。
Gallstones are common and contribute to morbidity and health-care costs, but their effects on mortality are unclear. We examined whether gallstone disease was associated with overall and cause-specific mortalities in a prospective national population-based sample. We analyzed data from 14,228 participants in the third U.S. National Health and Nutrition Examination Survey (20–74 years old) who underwent gallbladder ultrasonography from 1988 to 1994. Gallstone disease was defined as ultrasound-documented gallstones or evidence of cholecystectomy. The underlying cause of death was identified from death certificates collected through 2006 (mean follow up=14.3 years). Mortality hazard ratios (HR) were calculated using Cox proportional hazards regression analysis, to adjust for multiple demographic and cardiovascular-disease risk factors. The prevalence of gallstones was 7.1% and of cholecystectomy was 5.3%. During a follow-up period of 18 years or more, the cumulative mortality was 16.5% from all causes (2,389 deaths), 6.7% from cardiovascular disease (886 deaths), and 4.9% from cancer (651 deaths). Participants with gallstone disease had higher all-cause mortality in age-adjusted (HR, 1.3; 95% confidence interval [CI], 1.2–1.5) and multivariate-adjusted analysis (HR, 1.3; 95% CI, 1.1–1.5). A similar increase was observed for cardiovascular disease mortality (multivariate-adjusted HR, 1.4; 95% CI, 1.2–1.7) and cancer mortality (multivariate-adjusted HR, 1.3; 95% CI, 0.98–1.8). Individuals with gallstones had a similar increase in risk of death as those with cholecystectomy (multivariate-adjusted HR, 1.1; 95% CI, 0.92–1.4). In the U.S. population, persons with gallstone disease have increased mortality, overall, and mortalities from cardiovascular disease and cancer. This relationship was found for both ultrasound-diagnosed gallstones and cholecystectomy.
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影响因子：
5
作者：
BORTNICHAK, EA;FREEMAN, DH;MCNAMARA, PM
通讯作者：
MCNAMARA, PM
影响因子：
37.8
作者：
Menke, Andy;Muntner, Paul;Guallar, Eliseo
通讯作者：
Guallar, Eliseo
DOI：
10.1093/jnci/dji039
发表时间：
2005-02-16
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Michels, KB;Willett, WC;Giovannucci, E
通讯作者：
Giovannucci, E
影响因子：
13.5
作者：
Ruhl, CE;Everhart, JE
通讯作者：
Everhart, JE
影响因子：
5
作者：
Ruhl, CE;Everhart, JE
通讯作者：
Everhart, JE