解放军医学院学报2026，Vol.47Issue(1)：41-50,10.DOI:10.12435/j.issn.2095-5227.25100901
某三甲医院老年住院患者下尿路症状的关联因素分析和风险预测模型构建研究
Factors associated with lower urinary tract symptoms and related prediction model in elderly inpatients in a tertiary hospital
摘要
Abstract
Background With the aging population,lower urinary tract symptoms(LUTS)have emerged as a major global public health issue,therefore,conducting an in-depth exploration of its effective prevention and treatment strategies has become particularly urgent.Objective To analyze the relevant factors associated with LUTS in the elderly and construct a risk assessment model.Methods A retrospective cohort study was performed in elderly patients aged≥60 years hospitalized at the First Medical Center of PLA General Hospital from January 2023 to January 2024.Participants were divided into LUTS group and non-LUTS group based on the presence or absence of LUTS.Given the significant gender differences in LUTS etiology and manifestations,all analyses in this study were stratified by sex.Clinical data were collected for both groups.Multivariate logistic regression was used to identify independent factors associated with elderly LUTS.Forest plots were constructed,and model performance was evaluated using receiver operating characteristic(ROC)curves,clinical calibration curves,and decision analysis curves(DCA).Results This study included a total of 4 122 hospitalized elderly patients,comprising 2 394 males and 1 728 females.Among them,594 cases(14.48%)had LUTS,including 438 males(18.30%)and 159 females(9.20%).Multivariate logistic regression analysis showed that age(OR=1.051,95%CI:1.022-1.084),constipation(OR=1.583,95%CI:1.250-2.002),diabetes mellitus(OR=2.591,95%CI:1.949-3.443),history of surgery(OR=2.334,95%CI:1.781-3.043),benign prostatic hyperplasia(OR=2.920,95%CI:2.262-3.781),hypertension(OR=2.771,95%CI:2.082-3.689),cerebrovascular disease(OR=2.620,95%CI:1.991-3.438),and coronary heart disease(OR=1.451,95%CI:1.162-1.823)were independent associated factors for LUTS in elderly men.Age(OR=1.030,95%CI:1.010-1.050),surgical history(OR=1.960,95%CI:1.490-2.580),diabetes(OR=3.380,95%CI:2.600-4.420),cerebrovascular disease(OR=4.810,95%CI:3.330-6.980),Parkinson's disease(OR=4.350,95%CI:3.240-5.910),hypertension(OR=3.830,95%CI:2.820-5.240),atherosclerosis(OR=4.670,95%CI:3.590-6.100),and calcium channel blockers(OR=1.820,95%CI:1.390-2.390)were independent associated factors for LUTS in elderly women.The areas under the ROC curves(AUC)were 0.856(95%CI:0.840-0.872)and 0.839(95%CI:0.819-0.860),respectively.Calibration curves demonstrated high model calibration(χ2=5.689,P=0.772;χ2=6.375,P=0.703),while decision curve analysis indicated clinically meaningful net benefit within specific intervals.Conclusion The present study identifies the independent associated factors of LUTS in hospitalized elderly male and female patients,and develops gender-stratified Logistic risk assessment models.Through multidimensional model validation,the models demonstrate good discrimination,calibration,and clinical net benefit,and provide a reliable quantitative reference for early screening,individualized prevention,and clinical decision-making regarding LUTS in hospitalized elderly patients.关键词
下尿路症状/老年人/预测模型/Logistic模型/ROC曲线/性别因素Key words
lower urinary tract symptoms/elderly population/associated factors/risk assessment model分类
医药卫生引用本文复制引用
弓欣艳,于祥,王宝龙,冀雨薇,路望,乌日力格,蔡广研,张伟光,冯哲..某三甲医院老年住院患者下尿路症状的关联因素分析和风险预测模型构建研究[J].解放军医学院学报,2026,47(1):41-50,10.基金项目
国家重点研发计划(2022YFC3602903) （2022YFC3602903）
