PURPOSE: To investigate the short-term mortality of middle-aged patients undergoing cataract surgery in the United Kingdom (UK), to compare this with the expected mortality for the UK population of similar age and to try to identify at-risk groups. METHODS: In a retrospective study, the 5-10 year mortality of all middle-aged patients undergoing cataract surgery between 1989 and 1993 was determined. Expected mortality was calculated from UK Interim Life Tables for 1991. Cox's regression analysis was performed using age, sex and self-assigned ethnic group as variables. RESULTS: From the 709 patients in the study group, there were 86 deaths. This is significantly greater than expected (p < 0.01). Ethnic minority status (hazard ratio = 1.72, confidence interval = 1.12-2.64) and male sex (HR = 1.68, CI = 1.08-2.63) were found to be significantly associated with early mortality (p < 0.05). CONCLUSIONS: This study suggests that, for some middle-aged patients, cataract is associated with a reduced life expectancy and may be a feature of premature ageing, reflecting systemic ill-health. Screening these and younger patients for systemic disease when they present with cataract provides the best opportunity to affect this increased mortality. The findings of this study are particularly relevant for patients from ethnic minority groups.
PURPOSE: To investigate the short-term mortality of middle-aged patients undergoing cataract surgery in the United Kingdom (UK), to compare this with the expected mortality for the UK population of similar age and to try to identify at-risk groups. METHODS: In a retrospective study, the 5-10 year mortality of all middle-aged patients undergoing cataract surgery between 1989 and 1993 was determined. Expected mortality was calculated from UK Interim Life Tables for 1991. Cox's regression analysis was performed using age, sex and self-assigned ethnic group as variables. RESULTS: From the 709 patients in the study group, there were 86 deaths. This is significantly greater than expected (p < 0.01). Ethnic minority status (hazard ratio = 1.72, confidence interval = 1.12-2.64) and male sex (HR = 1.68, CI = 1.08-2.63) were found to be significantly associated with early mortality (p < 0.05). CONCLUSIONS: This study suggests that, for some middle-aged patients, cataract is associated with a reduced life expectancy and may be a feature of premature ageing, reflecting systemic ill-health. Screening these and younger patients for systemic disease when they present with cataract provides the best opportunity to affect this increased mortality. The findings of this study are particularly relevant for patients from ethnic minority groups.