Jori S Pesonen1,2,3, Rufus Cartwright4,5, Robin W M Vernooij6, Yoshitaka Aoki7, Arnav Agarwal8, Altaf Mangera9, Alayne D Markland10,11, Johnson F Tsui12, Henrikki Santti13,14, Tomas L Griebling15, Alexey E Pryalukhin16,17, Jarno Riikonen2,3, Riikka M Tähtinen18, Camille P Vaughan11,19, Theodor M Johnson11,19, Anssi Auvinen20, Diane Heels-Ansdell21, Gordon H Guyatt21,22, Kari A O Tikkinen13,14. 1. Department of Urology, Päijät-Häme Central Hospital, Lahti, Finland. 2. Department of Urology, Tampere University Hospital, Tampere, Finland. 3. Faculty of Medicine and Life Science, University of Tampere, Tampere, Finland. 4. Department of Epidemiology and Biostatistics, Imperial College, London, United Kingdom. 5. Department of Urogynaecology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom. 6. Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands. 7. Department of Urology, University of Fukui, Fukui, Japan. 8. Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 9. Department of Urology, Sheffield Teaching Hospitals, Sheffield, United Kingdom. 10. Department of Medicine and Division of Gerontology, Geriatrics and Palliative Care, University of Alabama Birmingham School of Medicine, Birmingham, Alabama. 11. Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, Georgia. 12. Department of Urology, Hackensack University Medical Center, New Jersey. 13. Department of Urology, University of Helsinki, Helsinki, Finland. 14. Helsinki University Hospital, Helsinki, Finland. 15. Department of Urology and The Landon Center On Aging, University of Kansas, Kansas City, Kansas. 16. Department of Urology, North-Western State Medical University named after I. I. Mechnikov, Saint Petersburg, Russia. 17. Department of Pathology, University Hospital of Bonn, Bonn, Germany. 18. Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland. 19. Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia. 20. Faculty of Social Sciences, University of Tampere, Tampere, Finland. 21. Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. 22. Department of Medicine, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Abstract
PURPOSE: Nocturia (waking from sleep at night to void) is a common cause of sleep disruption associated with increased comorbidity and impaired quality of life. However, its impact on mortality remains unclear. We performed a systematic review and meta-analysis to evaluate the association of nocturia with mortality as a prognostic factor and a causal risk factor. MATERIALS AND METHODS: We searched PubMed®, Scopus®, CINAHL® (Cumulative Index of Nursing and Allied Health Literature) and major conference abstracts up to December 31, 2018. Random effects meta-analyses were done to address the adjusted RR of mortality in people with nocturia. Meta-regression was performed to explore potential determinants of heterogeneity, including the risk of bias. We applied the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) framework to rate the quality of evidence for nocturia as a prognostic risk factor for mortality and separately as a cause of mortality. RESULTS: Of the 5,230 identified reports 11 observational studies proved eligible for inclusion. To assess nocturia 10 studies used symptom questionnaires and 1 used frequency-volume charts. Nocturia was defined as 2 or more episodes per night in 6 studies (55%) and as 3 or more episodes per night in 5 (45%). Pooled estimates demonstrated a RR of 1.27 (95% CI 1.16-1.40, I2=48%) with an absolute 1.6% and 4.0% 5-year mortality difference in individuals 60 and 75 years old, respectively. The pooled estimates of relative risk did not differ significantly across varying age, gender, followup, nocturia case definition, risk of bias or study region. We rated the quality of evidence for nocturia as a prognostic factor as moderate and as a cause of mortality as very low. CONCLUSIONS: Nocturia is probably associated with an approximately 1.3-fold increased risk of death.
PURPOSE:Nocturia (waking from sleep at night to void) is a common cause of sleep disruption associated with increased comorbidity and impaired quality of life. However, its impact on mortality remains unclear. We performed a systematic review and meta-analysis to evaluate the association of nocturia with mortality as a prognostic factor and a causal risk factor. MATERIALS AND METHODS: We searched PubMed®, Scopus®, CINAHL® (Cumulative Index of Nursing and Allied Health Literature) and major conference abstracts up to December 31, 2018. Random effects meta-analyses were done to address the adjusted RR of mortality in people with nocturia. Meta-regression was performed to explore potential determinants of heterogeneity, including the risk of bias. We applied the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) framework to rate the quality of evidence for nocturia as a prognostic risk factor for mortality and separately as a cause of mortality. RESULTS: Of the 5,230 identified reports 11 observational studies proved eligible for inclusion. To assess nocturia 10 studies used symptom questionnaires and 1 used frequency-volume charts. Nocturia was defined as 2 or more episodes per night in 6 studies (55%) and as 3 or more episodes per night in 5 (45%). Pooled estimates demonstrated a RR of 1.27 (95% CI 1.16-1.40, I2=48%) with an absolute 1.6% and 4.0% 5-year mortality difference in individuals 60 and 75 years old, respectively. The pooled estimates of relative risk did not differ significantly across varying age, gender, followup, nocturia case definition, risk of bias or study region. We rated the quality of evidence for nocturia as a prognostic factor as moderate and as a cause of mortality as very low. CONCLUSIONS:Nocturia is probably associated with an approximately 1.3-fold increased risk of death.
Authors: Kim Pauwaert; An-Sofie Goessaert; Lynn Ghijselings; Thomas F Monaghan; Herman Depypere; Karel Everaert Journal: Int Urogynecol J Date: 2021-01-13 Impact factor: 2.894