faA prediction model for lower urinary tract symptoms in men aged ≥50 years in a primary care-based population. Database research within the Registration Network Groningen.

Brunninkhuis, E.J.M. (2013) faA prediction model for lower urinary tract symptoms in men aged ≥50 years in a primary care-based population. Database research within the Registration Network Groningen. thesis, Medicine.

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Abstract

Introduction: Lower Urinary Tract Symptoms (LUTS) describe a variety of micturition problems, and affects both sexes. LUTS is very common, with an increasing prevalence with age. This study regards men, it is known that 60% of them consult their general practitioner (GP) for LUTS. For a long time prostatic enlargement was assumed to cause these symptoms. Recently, new insights showed that the etiology is not pure organic, instead, a more global view is needed focusing on the lower urinary tract as an integrated functional unit. Previous research has been done to investigate associated factors and comorbidities. In this study, primary objective was to explore risk factors for LUTS in primary care-based population. Possibly, this leads to a better awareness of GPs for patients at risk for LUTS. In literature an association between cardiovascular diseases and LUTS was described. Therefore a secondary objective was to investigate if patients who are checked for cardiovascular risk factors (CVRM) by the practice nurse (POH) are more likely to have LUTS. Materials and methods: A retrospective cohort study based on a primary care population. Men aged ≥50 years with LUTS and men aged ≥50 years without LUTS were included from three general practices within the Registration Network Groningen (RNG) in the period from January 1998 until January 2012. LUTS were defined as present if the patient was diagnosed with at least one of the following ICPC codes: U02, U05, U07, U13, U29, Y06, or Y85. Data collected include patient number, date of birth, person days, contact types, contact dates, ICPC codes and medication use. We explored risk factors and comorbidities, serving as potential predictors for LUTS. Multivariate logistic regression analysis and Cox regression backward analysis were executed to assess determinants of LUTS. Results: 5957 men ≥50 years were included in the total population, 1284 men (21.6%) were registered with LUTS. Patients with LUTS were on average older (70.5±12.0 years) than men without LUTS (65.3±11.4 years). COPD, depression, erectile dysfunction, constipation, hypertension, dementia, sterilization, a history of sexually transmitted disease, urinary tract infection/cystitis, anxiety and heart failure were significant predictors for LUTS, as were the use of antidepressants, inhalation medication, cardiaca, antihypertensives and antipsychotics. Strong predictors (p<0.01) for an increased risk of LUTS were: (HR, 95% CI) erectile dysfunction (2.00, 1.03-2.40), sterilization (1.70, 1.47-1.96), anxiety (1.51, 1.11-2.06), depression (1.45, 1.24-1.69) and the use of antidepressants (1.42, 1.24-1.64). Conclusion: 16 determinants were significant predictors for LUTS. The underlying pathophysiology of LUTS and associated determinants is not clear yet. Erectile dysfunction, sterilization, anxiety, depression, and the use of antidepressants appear to be strong predictors increasing the risk of LUTS. These identified predictors help general practitioners to improve the care of patients at risk for LUTS, by extending anamnesis and to focus on specific factors.

Item Type:	Thesis (Thesis)
Supervisor name:	Heide, W.K. van der MD and Bouwman, I.I. MD and Groenhof, F.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:57
Last Modified:	25 Jun 2020 10:57
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1768

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