The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta-analysis of observational studies.
Por:
Soysal P, Veronese N, Ippoliti S, Pizzol D, Carrie AM, Stefanescu S, López-Sánchez GF, Barnett Y, Butler L, Koyanagi A, Jacob L., Ghaydya RA, Sheyn D, Hijaz AK, Oliva-Lozano JM, Muyor JM, Trott M, Kronbichler A, Grabovac I, Tully MA, Yang L, Hwang J, Kim JY, Park S, Song J, Shin JI, Ilie PC and Smith L
Publicada:
1 mar 2023
Ahead of Print:
13 ene 2023
Resumen:
BACKGROUND AND AIM: We aimed to capture the breadth of health outcomes that have been associated with the presence of Urinary Incontinence (UI) and systematically assess the quality, strength, and credibility of these associations through an umbrella review and integrated meta-analyses. METHODS: We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p-values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV). RESULTS AND DISCUSSION: From 3172 articles returned in search of the literature, 9 systematic reviews were included with a total of 41 outcomes. Overall, 37 out of the 41 outcomes reported nominally significant summary results (p < 0.05), with 22 associations surviving the application of a more stringent p-value (p < 10(-6)). UI was associated with worse scores than controls in female sexual function (Class II), while it was also associated with a higher prevalence of depression (odds ratio [OR] = 1.815; 95% confidence interval [CI]: 1.551-2.124), and anxiety (OR = 1.498; 95% CI: 1.273-1.762) (Class IV). UI was associated with poorer quality of life (QoL), higher rate of mortality (hazard ratio = 2.392; 95% CI: 2.053-2.787) an increase in falls, frailty, pressure ulcers, diabetes, arthritis, and fecal incontinence (Class IV). CONCLUSIONS: UI is associated with female sexual dysfunction, with highly suggestive evidence. However, the evidence of other adverse outcomes including depression, anxiety, poorer QoL, higher mortality, falls, pressure ulcers, diabetes, arthritis, fecal incontinence, and frailty is only weak. A multidimensional approach should be taken in managing UI in the clinical setting.
Filiaciones:
Soysal P:
Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvari (Vatan Street), Fatih, 34093, Istanbul, Turkey
Veronese N:
Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
Ippoliti S:
Urology Department, Hull University Teaching Hospitals NHS Trust, Hull, UK
Pizzol D:
Italian Agency for Development Cooperation, 33 Street, Amarat, 79371, Khartoum, Sudan
Carrie AM:
The Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
Stefanescu S:
The Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
López-Sánchez GF:
Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
Barnett Y:
Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
Butler L:
Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
Koyanagi A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08830, Barcelona, Spain
ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
Jacob L.:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08830, Barcelona, Spain
Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
Ghaydya RA:
Department of Urology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, USA
Case Western Reserve University School of Medicine, Cleveland, OH, USA
Sheyn D:
Department of Urology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, USA
Case Western Reserve University School of Medicine, Cleveland, OH, USA
Hijaz AK:
Department of Urology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, USA
Case Western Reserve University School of Medicine, Cleveland, OH, USA
Oliva-Lozano JM:
Health Research Centre, University of Almeria, Almeria, Spain
Muyor JM:
Health Research Centre, University of Almeria, Almeria, Spain
Trott M:
Centre for Public Health, Queen's University Belfast, Belfast, UK
Kronbichler A:
Department of Internal Medicine IV, Medical University Innsbruck, Innsbruck, Austria
Grabovac I:
Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090, Vienna, Austria
Tully MA:
School of Medicine, Ulster University, Londonderry, BT48 7JL, UK
Yang L:
Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Canada
Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
Hwang J:
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Kim JY:
Yonsei University College of Medicine, Seoul, Republic of Korea
Park S:
Yonsei University College of Medicine, Seoul, Republic of Korea
Song J:
Keimyung University School of Medicine, Daegu, Republic of Korea
Shin JI:
Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Ilie PC:
Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
Smith L:
Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
Open Access
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