Risk factors for inguinal hernia among adults in the US population
Risk factors for inguinal hernia among adults in the US population
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DOI：
10.1093/aje/kwm011
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发表时间：
2007-05-15
影响因子：
5
通讯作者：
Everhart, James E.
中科院分区：
文献类型：
--
作者：
Ruhl, Constance E.;Everhart, James E.
作者研究了参与第一次全国健康和营养检查调查（1971-1975）的美国成年人（5，316名男性和8，136名女性）中发生腹股沟疝的风险因素，这些成年人在1992-1993年被随访，以获得医院（国际疾病分类，第九次修订，临床修改，代码550）或医生诊断的腹股沟疝。96%的基线队列患者再次接受了治疗，中位随访时间为18.2年（范围：0.02-22.1年）。由于男性腹股沟疝的累积发病率（13.9%）高于女性（2.1%），因此对男性进行了更详细的分析。在多变量分析中，腹股沟疝的发病年龄与40-59岁有关（P < 0.05）（风险比（HR）= 2.2，95%置信区间（CI）：1.7，2.8），年龄60-74岁（HR = 2.8，95% CI：2.2，3.6）和食管裂孔疝（HR = 1.8，95% CI：1.2，2.7），而黑人（HR = 0.58，95%CI：0.42，0.79）、超重（HR = 0.79，95%CI：0.66，0.95）和肥胖（HR = 0.51，95%CI：0.36，0.71）与较低的发病率相关。在女性中，年龄较大、居住在农村、身高较高、慢性咳嗽和脐疝与腹股沟疝相关。在美国，腹股沟疝在男性中很常见，尤其是随着年龄的增长。体重较重的男性患病风险较低，这是出乎意料的，需要进一步研究。
The authors examined risk factors for incident inguinal hernia among US adults (5,316 men and 8,136 women) participating in the First National Health and Nutrition Examination Survey (1971-1975) who were followed through 1992-1993 for a hospital (International Classification of Diseases, Ninth Revision, Clinical Modification, code 550) or physician diagnosis of inguinal hernia. Ninety-six percent of the baseline cohort was recontacted, with a median follow-up of 18.2 years (range, 0.02-22.1 years). Because the cumulative incidence of inguinal hernia was higher among men (13.9%) than among women (2.1%), more detailed analyses were conducted in men. Among men in multivariate analysis, a higher incidence (p < 0.05) of inguinal hernia was associated with an age of 40-59 years (hazard ratio (HR) = 2.2, 95% confidence interval (CI): 1.7, 2.8), an age of 60-74 years (HR = 2.8, 95% CI: 2.2, 3.6), and hiatal hernia (HR = 1.8, 95% CI: 1.2, 2.7), while Black race (HR = 0.58, 95% CI: 0.42, 0.79), being overweight (HR = 0.79, 95% CI: 0.66, 0.95), and obesity (HR = 0.51, 95% CI: 0.36, 0.71) were associated with a lower incidence. Among women, older age, rural residence, greater height, chronic cough, and umbilical hernia were associated with inguinal hernia. In the United States, inguinal hernias are common among men, especially with aging. The lower risk among heavier men was unexpected and bears further study.