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首页> 外文期刊>BJU international >Cluster analysis and lower urinary tract symptoms in men: findings from the Boston Area Community Health Survey.
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Cluster analysis and lower urinary tract symptoms in men: findings from the Boston Area Community Health Survey.

机译：男性的聚类分析和下尿路症状：波士顿地区社区健康调查的结果。

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OBJECTIVES: To classify lower urinary tract symptoms (LUTS) in a large, representative sample of men in the USA by means of cluster analysis and to investigate risk factors and comorbidities associated with the resulting cluster patterns. SUBJECTS AND METHODS: A combination of hierarchical and non-hierarchical cluster methods was used to assign men with LUTS in the Boston Area Community Health (BACH) study to symptom-based categories or clusters. Of the 2301 men in the BACH study, those reporting one or more of 14 common LUTS (1592 men) were included in the analysis. The prevalence and frequency of symptoms in each cluster was assessed, in addition to the demographic, lifestyle risk factors, comorbidities, quality of life, and interference with activities of daily living associated with each cluster. We used anova methods for assessing cluster effects on continuous variables, and cross-classification and chi-square tests for categorical measures. Internal validity of the cluster solution was tested by means of a split-half replication, and external validity by comparison with previously published data. RESULTS: Five clusters were identified among symptomatic men. About half of the symptomatic men were assigned to Cluster 1, which included individuals with a low prevalence and frequency of urological symptoms and a correspondingly low level of interference with activities of daily living. There were intermediate levels of symptom frequency and prevalence in Clusters 2-4, which were characterized by mixed patterns of voiding, storage and postvoiding symptoms. Cluster 5 consisted of predominantly older men (mean age 58.9 years), with a high prevalence and frequency of urological symptoms with a mean (SD) number of symptoms of 9.9 (2.1), and with elevated levels of comorbid cardiovascular disease (P < 0.001). These men also had higher rates of kidney and bladder infections and previous urological surgery. Men with increased waist circumference and more sedentary lifestyles were over-represented in the more symptomatic clusters. CONCLUSION: Cluster analysis provides an empirically based method for categorizing men with LUTS. These findings provide a new framework for examining aetiological pathways and mechanisms, the potential impact of and consequences for comorbid conditions, and for assessing prognosis and outcomes associated with common urological disorders.
机译：目的：通过聚类分析对美国大型男性代表性样本中的下尿路症状（LUTS）进行分类，并调查与由此产生的聚类模式相关的危险因素和合并症。受试者与方法：在波士顿地区社区卫生（BACH）研究中，使用分层和非分层聚类方法的组合将患有LUTS的男性分配给基于症状的类别或聚类。在BACH研究中的2301名男性中，报告了14种常见LUTS中的一项或多项的男性（1592名男性）被纳入分析。除了人口统计学，生活方式风险因素，合并症，生活质量以及对与每个群集相关的日常生活活动的干扰之外，还评估了每个群集中症状的患病率和频率。我们使用了方差分析方法来评估聚类对连续变量的影响，并使用交叉分类和卡方检验进行分类。集群解决方案的内部有效性通过半拆分复制进行了测试，外部有效性通过与先前发布的数据进行了比较。结果：在有症状的男性中鉴定出五个簇。大约一半有症状的男性被分配到第一类，其中包括患病率和尿毒症症状发生率较低且对日常生活活动的干扰程度相对较低的人。集群2-4中出现症状频率和患病率的中间水平，其特征在于排尿，贮藏和回避症状的混合模式。第5类人群主要是年龄较大的男性（平均年龄58.9岁），泌尿系统症状的患病率和发生率较高，平均症状数（SD）为9.9（2.1），合并心血管疾病的水平较高（P <0.001） ）。这些男人还具有较高的肾脏和膀胱感染率以及以前的泌尿外科手术。腰围增加和久坐不动的生活方式的男性在症状较多的人群中占了过多。结论：聚类分析提供了一种基于经验的LUTS男性分类方法。这些发现为检查病因学途径和机制，合并症的潜在影响和后果以及评估与常见泌尿科疾病相关的预后和结果提供了新的框架。

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