Comparison of Comorbid Conditions between Open-Angle Glaucoma Patients and a Control Cohort A Case-Control Study
Comparison of Comorbid Conditions between Open-Angle Glaucoma Patients and a Control Cohort A Case-Control Study
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DOI：
10.1016/j.ophtha.2010.03.003
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发表时间：
2010-11-01
期刊：
影响因子：
13.7
通讯作者：
Ho, Jau-Der
中科院分区：
文献类型：
--
作者：
Lin, Herng-Ching;Chien, Ching-Wen;Ho, Jau-Der
目的：确定开角型青光眼（OAG）患者中某些合并症的患病率，以及这些合并症在OAG患者中是否比无OAG患者更普遍。设计：一项使用行政数据库的全国性回顾性病例对照研究。研究对象：研究组包括76 673例OAG患者。对照组包括与研究队列相匹配的23019名受试者。方法：回顾性收集台湾全民健康保险研究数据库资料。研究队列包括2005年诊断为OAG（国际疾病分类，第9版，临床修改代码365.1-365.11）的所有患者（n = 76673）。对照队列随机选取年龄、性别、城市化水平、月收入与研究组相匹配的患者（每1例OAG患者中有3例，n = 23019）。根据Elixhauser合并症指数，共选择31种医学合并症。使用单独的条件logistic回归分析来估计有OAG和无OAG患者之间每种医学合并症的校正优势比。主要观察指标：选定的合并症的患病率。结果：超过一半（50.5%）的OAG患者有高血压，超过30%的OAG患者有高脂血症或糖尿病（分别为30.5%和30.2%）。经年龄、性别、城市化水平和月收入调整后，OAG患者31项合并症中28项的患病率明显高于非青光眼患者。高血压、高脂血症、系统性红斑狼疮、糖尿病、甲状腺功能减退、体液和电解质紊乱、抑郁症和精神病的校正优势比大于1.50。在研究的合并症中，OAG组与对照组在高血压、高脂血症、中风、糖尿病、肝病和消化性溃疡方面的患病率差异为3%或更高。结论：开角型青光眼患者明显更容易出现合并症，其中许多合并症可能危及生命或明显影响生活质量。财务披露：作者在本文中讨论的任何材料中没有专有或商业利益。眼科2010;117: 2088-2095 (C) 2010由美国眼科学会。
Objective: To determine the prevalence of selected comorbidities in patients with open-angle glaucoma (OAG) and whether these comorbidities are more prevalent among individuals with OAG than those without OAG.Design: A retrospective, nationwide, case-control study using an administrative database.Participants: The study group comprised 76 673 OAG patients. The comparison group comprised 230 019 subjects matched to the study cohort.Methods: Data were collected retrospectively from the Taiwan National Health Insurance Research Database. The study cohort comprised all patients with a diagnosis of OAG (International Classification of Diseases, 9th Revision, Clinical Modification codes 365.1-365.11) in 2005 (n = 76 673). The comparison cohort comprised randomly selected patients (3 for every 1 OAG patient; n = 230 019) matched with the study group in terms of age, gender, urbanization level, and monthly income. In total, 31 medical comorbidities were selected based mainly on the Elixhauser Comorbidity Index. Separate conditional logistic regression analyses were used to estimate the adjusted odds ratio for each of the medical comorbidities between patients with and without OAG.Main Outcome Measures: The prevalences of selected comorbidities.Results: More than half (50.5%) of the OAG patients had hypertension, and more than 30% had hyperlipidemia or diabetes (30.5% and 30.2%, respectively). The prevalences of 28 of 31 comorbidities were significantly higher for OAG patients than subjects without glaucoma after adjusting for age, gender, urbanization level, and monthly income. The adjusted odds ratio was more than 1.50 for hypertension, hyperlipidemia, systemic lupus erythematosus, diabetes, hypothyroidism, fluid and electrolyte disorders, depression, and psychosis. Among the studied comorbidities, the prevalence difference of the OAG group minus the control group was 3% or higher for hypertension, hyperlipidemia, stroke, diabetes, liver disease, and peptic ulcer.Conclusions: Open-angle glaucoma patients are significantly more likely to have comorbidities, many of which can be life threatening or can affect the quality of life appreciably.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2010; 117: 2088-2095 (C) 2010 by the American Academy of Ophthalmology.