膀胱癌患者肥胖和不同代谢状态与预后的关系:一项回顾性队列研究

IF 2.6 4区医学 Q2 UROLOGY & NEPHROLOGY Therapeutic Advances in Urology Pub Date : 2023-11-28 eCollection Date: 2023-01-01 DOI:10.1177/17562872231213720

Yingchun Dong, Yiping Cheng, Honglin Guo, Jiaxing Sun, Junming Han, Fang Zhong, Qihang Li, Dawei Wang, Wenbin Chen, Xiude Fan, Jiajun Zhao

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引用次数: 0

摘要

背景和目的:膀胱癌(BC)患者的复发率和再入院费用较高。然而，关于肥胖和代谢异常对BC预后的影响的证据并不一致。我们的主要目的是确定肥胖和不同代谢状态对BC患者再入院风险的影响。设计和方法:我们使用2018年全国再入院数据库确定了16,649例BC患者，这些患者于2018年1月至6月住院，随访180天。主要终点为180天再入院。采用多变量Cox回归分析和有序逻辑回归分析资料。结果:肥胖和代谢异常与BC患者再入院风险增加相关[肥胖:校正危险比(aHR) = 1.08, 95%可信区间(CI): 1.01-1.16;高血糖:aHR = 1.11, 95% CI: 1.05-1.17;高血压:aHR = 1.09, 95% CI: 1.03-1.15]。与非肥胖和无代谢异常的患者相比，代谢异常患者再入院的风险显著增加，与肥胖无关(非肥胖和代谢异常:aHR = 1.07, 95% CI: 1.02-1.13;肥胖和代谢异常:aHR = 1.20, 95% CI: 1.10-1.31)，但在肥胖和无代谢异常中没有。这些关联在60岁及以上的患者和手术组中是一致的。此外，高血糖、高血压和代谢风险分级增加与再入院风险增加相关。我们还发现肥胖和代谢异常患者再入院的住院时间增加(aOR = 1.17, 95% CI: 1.00-1.36)。结论:肥胖合并代谢异常和单独代谢异常与BC患者更高的再入院风险相关。建议预防不仅应关注肥胖，还应关注代谢异常，以降低再入院的风险。

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Association of obesity and different metabolic status with prognosis in patients with bladder cancer: a retrospective cohort study.

Background and objectives: Patients with bladder cancer (BC) are at high risk for recurrence rates and readmission costs. However, the evidence about obesity and metabolic abnormalities on the BC prognosis was inconsistent. Our primary aim was to determine the impact of obesity and different metabolic status on the readmission risk in patients with BC.

Design and methods: We identified 16,649 patients with BC using the 2018 Nationwide Readmissions Database who were hospitalized from January to June 2018 and followed for 180 days. The primary outcome was 180-day readmission. The multivariate Cox regression analysis and ordered logistic regression were performed to analyze data.

Results: Obesity and metabolic abnormalities were associated with an increased readmission risk in patients with BC [obesity: adjusted hazard ratio (aHR) = 1.08, 95% confidence interval (CI): 1.01-1.16; hyperglycemia: aHR = 1.11, 95% CI: 1.05-1.17; hypertension: aHR = 1.09, 95% CI: 1.03-1.15]. Compared with non-obese and no metabolic abnormalities, the risk of readmission was significantly increased in patients with metabolic abnormalities, irrespective of obesity (non-obese and metabolic abnormalities: aHR = 1.07, 95% CI: 1.02-1.13; obese and metabolic abnormalities: aHR = 1.20, 95% CI: 1.10-1.31), but not in obese and no metabolic abnormalities. These associations were consistent in patients aged 60 years or older and the surgery group. Moreover, hyperglycemia, hypertension, and a graded increment of metabolic risk were associated with an increased readmission risk. We also found increased length of stay for readmission in patients with obesity and metabolic abnormalities (aOR = 1.17, 95% CI: 1.00-1.36).

Conclusion: Obesity with metabolic abnormalities and metabolic abnormalities alone were associated with higher readmission risks in patients with BC. It is suggested that prevention should focus not only on obesity but also on metabolic abnormalities to decrease the risk of readmission.

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来源期刊

Therapeutic Advances in Urology Medicine-Urology

CiteScore

3.70

自引率

0.00%

发文量

审稿时长

10 weeks

期刊介绍： Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.