基于竞争风险模型的离退休人员白内障发病的影响因素分析

目的 应用竞争风险模型，探究离退休人员白内障发病的影响因素，为离退休人员的白内障预防和早期干预提供科学依据。方法 将历年参与杭州市萧山区55岁及以上离退休人员体检项目的人员作为研究对象，纳入前瞻性队列研究，收集研究对象所有可能的影响因素，拟合竞争风险模型，分析研究对象白内障发病的影响因素。结果 纳入队列的研究对象共计2 181人，经过8年的随访失访188人，发生白内障（终点事件）923人，发病率为42.3%，在发生白内障之前死亡或失明（竞争事件）294人，累积观察到12 575人年，竞争风险模型分析显示，在有竞争事件的影响下，女性（HR=1.371, 95%CI:1.202～1.565）、年龄≥70岁（HR=1.027, 95%CI:1.020～1.034）、教育程度为中学（HR=1.940, 95%CI:1.673～2.250）或大专及以上（HR=1.301, 95%CI:1.104～1.533）、高血压（HR=1.384, 95%CI:1.216～1.575）、糖尿病（HR=1.303, 95%CI:1.144～1.484）、高血脂（HR=1.209, 95%CI:1.063～1....

Influencing factors of cataract in retirees based on competitive risk model

Objective To explore the influencing factors of cataract in retirees by using competitive risk model, so as to provide scientific basis for cataract prevention and early intervention. Methods The retirees aged 55 and above in Xiaoshan District of Hangzhou were enrolled in the prospective cohort study. All possible influencing factors were collected and the competitive risk model was fitted. The influencing factors of cataract were analyzed. Results A total of 2 181 subjects were enrolled in the cohort. After 8 years of follow-up, 188 were lost to follow-up, 923 had cataract (endpoint event), with an incidence of 42.3%, and 294 died or lost sight (competitive event) before the occurrence of cataract, with cumulative observation of 12 575 person-years. Competitive risk model analysis showed, under the influence of competitive events, female (HR=1.371, 95%CI: 1.202-1.565), age ≥ 70 (HR=1.027, 95%CI: 1.020-1.034), secondary school education (HR=1.940, 95%CI: 1.673-2.250) or junior college or above (HR=1.301, 95%CI: 1.104-1.533), hypertension (HR=1.384, 95%CI: 1.216-1.575), diabetes (HR=1.303, 95%CI: 1.144-1.484), hyperlipidemia (HR=1.209, 95%CI: 1.063-1.375), smoking (HR=1.218, 95%CI: 1.036-1.433), family history of cataract (HR=1.418, 95%CI: 1.237-1.625), and sleep disorders (HR=2.649, 95%CI: 2.089-3.360; HR=2.776, 95%CI: 2.252-3.422) were risk factors of cataract occurrence. Daily outdoor activity > 4 h (HR=0.763, 95%CI: 0.651-0.894) was protective factor of cataract occurrence. Conclusion The incidence of cataract among retirees in Xiaoshan District is high, which is affected by multiple factors. Cataract screening should be carried out regularly in key population to reduce the incidence of cataract.