与青光眼疑似患者转为青光眼风险相关的社会因素：对全国范围内 "我们所有人 "计划的分析。

IF 2.8 Q1 OPHTHALMOLOGY Ophthalmology. Glaucoma Pub Date : 2024-11-01 DOI:10.1016/j.ogla.2024.06.007

Jo-Hsuan Wu MD , Willam Halfpenny MB BChir, MEng , Jennifer Bu MD , Manreet Brar BS , Robert N. Weinreb MD , Sally L. Baxter MD, MSc

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引用次数: 0

摘要

目的：研究与青光眼疑似患者（GS）5年后转为开角型青光眼（OAG）风险相关的社会因素：设计：回顾性队列分析：我们从 "我们所有人 "数据库中筛选出被诊断为青光眼的参与者。将在确诊为 GS 后 5 年内转为开角型青光眼的病例（"转为开角型青光眼组"）与未转为开角型青光眼的对照病例进行比较：方法：提取病例的人口统计学、社会经济和医疗保健使用数据，并在转化组和对照组之间进行比较。采用多变量考克斯比例危险模型确定与转归风险相关的潜在因素：主要结果测量：与转换风险相关的重要因素的危险比（HRs）：共发现5274例GS患者，其中786例（15%）在5年随访期内转为OAG。两组患者在年龄、种族、性别、就业状况、收入/教育水平、眼内手术史和医疗保健使用模式方面存在明显差异。在多变量模型中，非裔美国人/黑人种族（HR [95% 置信区间] =1.70 [1.44-2.00]）、GS 诊断年龄较大（1.17 [1.09-1.25]）、男性（1.30 [1.13-1.50]）、无娱乐性药物使用史（1.23 [1.07-1.42]）、眼内手术史（1.60[1.02-1.53]）和有更多延迟就医的原因（2.27[1.23-4.18]）与更大的转化风险相关，而有工作（0.71[0.60-0.86]）与较小的转化风险相关（PC 结论：一些社会因素与从 GS 转为 OAG 有关，这可能有助于识别疾病进展风险较高的患者。今后还需要开展研究，探讨这些发现的依据以及解决这些问题的潜在干预措施。

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Social Factors Associated with the Risk of Glaucoma Suspect Conversion to Glaucoma

Purpose

To examine social factors associated with the 5-year risk of glaucoma suspects (GS) converting to open-angle glaucoma (OAG).

Design

Retrospective cohort analysis.

Subjects

We screened for participants diagnosed with GS in the All of Us database. Cases that converted to OAG within 5 years of GS diagnosis (the “conversion group”) were compared with control cases that did not convert.

Methods

Demographic, socioeconomic and health-care utilization data of the cases were extracted and compared between the conversion group and the control group. Multivariable Cox proportional hazards modeling was used to identify potential factors associated with the risk of conversion.

Main Outcome Measures

Hazard ratios (HRs) of significant factors associated with the risk of conversion.

Results

A total of 5274 GS participants were identified, and 786 (15%) cases converted to OAG within 5-year follow-up. The 2 groups showed significant differences in age, race, gender, employment status, income/education level, history of intraocular surgery, and health-care utilization patterns. In the multivariable model, African American/Black race (HR : 1.70 [95% confidence interval (CI), 1.44–2.00]), older age at GS diagnosis (1.17 [95% CI, 1.09–1.25]), male gender (1.30 [95% CI, 1.13–1.50], no history of recreational drug use (1.23 [1.07–1.42]), history of intraocular surgery (1.60 [95% CI, 1.02–1.53]), and having more reasons for delayed health-care access (2.27 [95% CI, 1.23–4.18]) were associated with a greater hazard of conversion, while being employed (0.71 [95% CI, 0.60–0.86]) was associated with a smaller hazard of conversion (P < 0.05 for all).

Conclusions

Several social factors were associated with the conversion from GS to OAG, which may help to identify patients at higher risk of disease progression. Future studies are needed to examine the basis for these findings and the potential interventions that could address them.

Financial Disclosures

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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