Survival study of Parkinson disease in Olmsted county, Minnesota
Survival study of Parkinson disease in Olmsted county, Minnesota
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DOI：
10.1001/archneur.60.1.91
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发表时间：
2003-01-01
影响因子：
--
通讯作者：
Rocca, WA
中科院分区：
文献类型：
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作者：
Elbaz, A;Bower, JH;Rocca, WA
目的：比较生存的帕金森病（PD）的事件情况下，生存的PD从一般population.Methods：我们使用的医疗记录联动系统的罗切斯特流行病学项目，以确定事件的情况下，PD在奥姆斯特德县，明尼苏达州，在1976年至1995年期间。病例按年龄和性别与来自同一人群的参考受试者相匹配。对196例患者和185名参照对象，我们研究了PD诊断日期（或索引日期）与死亡、失访或研究结束（2000年5月1日）之间的生存率。结果：病例的中位随访时间为7.2年，参照对象为8.0年; 110例PD患者和79名参照对象在随访期间死亡。病例中位生存期为10.3年，对照组中位生存期为13.4年。死亡的相对风险（RR）总体为1.60（95%置信区间[CI]，1.20-2.14; P=.002），女性为1.81（95% CI，1.15-2.84; P=.01），男性为1.49（95% CI，1.01-2.20; P=.04）。根据PD发作时的年龄，死亡的RR有下降趋势（三分位数）：小于67岁，RR，2.04（95% CI，0.99-4.19; P=.05）; 67至76岁，RR，1.76（95% CI，1.08-2.86; P=.02）; 76岁以上，RR，1.48（95% CI，0.95-2.29; P=.08）。同时具有静止性震颤和明显不对称性的PD患者的预后比没有任何临床特征的患者更好。吸烟的PD患者的生存情况好于预期。结论：PD患者面临着更高的死亡风险，与普通人群中的PD患者相比。某些临床特征和吸烟改变生存率。
Objective: To compare survival in incident cases of Parkinson disease (PD) with survival in subjects free of PD from the general population.Methods: We used the medical records linkage system of the Rochester Epidemiology Project to identify incident cases of PD in Olmsted County, Minnesota, for the period 1976-1995. Cases were matched by age and sex to referent subjects from the same population. For 196 cases and 185 referent subjects, we studied survival between the date of diagnosis of PD (or index date) and death, loss to follow-up, or end of the study (May 1, 2000).Results: The median length of follow-up was 7.2 years for cases and 8.0 years for referent subjects; 110 patients with PD and 79 referent subjects died during follow-up. The median survival was 10.3 years in cases and 13.4 years in referent subjects. The relative risk (RR) of death was 1.60 (95% confidence interval [CI], 1.20-2.14; P=.002) overall, 1.81 (95% CI, 1.15-2.84; P=.01) in women, and 1.49 (95% Cl, 1.01-2.20; P=.04) in men. There was a decreasing trend in the RR of death according to age at onset of PD (in tertiles): younger than 67 years, RR, 2.04 (95% CI, 0.99-4.19; P=.05); 67 to 76 years, RR, 1.76 (95% CI, 1.08-2.86; P=.02); and older than 76 years, RR, 1.48 (95% CI, 0.95-2.29; P=.08). Patients with PD who had both rest tremor and pronounced asymmetry had a better prognosis than patients with neither clinical characteristic. Patients with PD who smoked survived better than expected.Conclusions: Patients with PD face a higher risk of death compared with subjects free of PD from the general population. Certain clinical characteristics and smoking modify survival.