杜普伊特伦氏病患者确诊后头 5 年的死亡率:基于人群的生存分析。

Bente A van den Berge, Feikje Groenhof, Paul M N Werker, Dominic Furniss, Rachel Kuo, Edwin R van den Heuvel, Dieuwke C Broekstra
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引用次数: 0

摘要

以往的研究表明,杜普伊特伦氏病与死亡率升高有关,但大多数研究未能考虑到重要的混杂因素。在这项基于人群的队列研究中,全科医生(GP)的数据与荷兰统计局的数据相链接,以登记全因死亡率和特定疾病死亡率。杜普伊特伦氏病患者是通过全科医生咨询中的相应诊断代码和评估自由文本字段确定的。通过多重估算来估计协变量的缺失值,然后进行1:7倾向评分匹配,以平衡病例与对照组的混杂因素。采用虚弱比例危险模型对两组患者的死亡率进行比较。在 209,966 名患者中,确定了 2561 名杜普伊特伦氏病患者,并与至少四名对照者进行了匹配。中位随访 5 年后发现,杜普伊特伦氏病患者的死亡率实际上有所下降。继发于癌症或心血管疾病的死亡率没有差异。今后使用纵向数据进行平均随访时间更长的研究应能从更长远的角度阐明这些关联:证据等级:III。
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Mortality in patients with Dupuytren's disease in the first 5 years after diagnosis: a population-based survival analysis.

Previous studies suggest that Dupuytren's disease is associated with increased mortality, but most studies failed to account for important confounders. In this population-based cohort study, general practitioners' (GP) data were linked to Statistics Netherlands to register all-cause and disease-specific mortality. Patients with Dupuytren's disease were identified using the corresponding diagnosis code and assessing free-text fields from GP consultations. Multiple imputations were performed to estimate missing values of covariates, followed by 1:7 propensity score matching to balance cases with controls on confounding factors. A frailty proportional hazard model was used to compare mortality between both groups. Out of 209,966 individuals, 2561 patients with Dupuytren's disease were identified and matched to at least four controls. After a median follow-up of 5 years, mortality was found to be actually reduced in patients with Dupuytren's disease. There was no difference in mortality secondary to cancer or cardiovascular disease. Future studies with longer average follow-up using longitudinal data should clarify these associations in the longer term.Level of evidence: III.

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