The Impact of Nocturia on Falls and Fractures : A Systematic Review and Meta-Analysis

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Pesonen , J S , Vernooij , R W M , Cartwright , R , Aoki , Y , Agarwal , A , Mangera , A , Markland , A D , Tsui , J F , Santti , H , Griebling , T L , Pryalukhin , A E , Riikonen , J , Tähtinen , R M , Vaughan , C P , Johnson , T M , Heels-Ansdell , D , Guyatt , G H & Tikkinen , K A O 2020 , ' The Impact of Nocturia on Falls and Fractures : A Systematic Review and Meta-Analysis ' , Journal of Urology , vol. 203 , no. 4 , pp. 674-683 . https://doi.org/10.1097/JU.0000000000000459

Title: The Impact of Nocturia on Falls and Fractures : A Systematic Review and Meta-Analysis
Author: Pesonen, Jori S.; Vernooij, Robin W. M.; Cartwright, Rufus; Aoki, Yoshitaka; Agarwal, Arnav; Mangera, Altaf; Markland, Alayne D.; Tsui, Johnson F.; Santti, Henrikki; Griebling, Tomas L.; Pryalukhin, Alexey E.; Riikonen, Jarno; Tähtinen, Riikka M.; Vaughan, Camille P.; Johnson, Theodore M.; Heels-Ansdell, Diane; Guyatt, Gordon H.; Tikkinen, Kari A. O.
Contributor: University of Helsinki, HYKS erva
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
Date: 2020-04
Language: eng
Number of pages: 10
Belongs to series: Journal of Urology
ISSN: 1527-3792
URI: http://hdl.handle.net/10138/324789
Abstract: Purpose: Although nocturia is associated with various comorbidities, its impact on falls and fractures remains unclear. We performed a systematic review and meta-analysis to evaluate the association between nocturia and falls and fractures as a prognostic and as a causal risk factor. Materials and Methods: We searched PubMed (R), Scopus (R), CINAHL (Cumulative Index to Nursing and Allied Health Literature) and abstracts of major urological meetings up to December 31, 2018. We conducted random effects meta-analyses of adjusted relative risks of falls and fractures. We applied the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to rate the quality of evidence for nocturia as a prognostic and causal factor of falls and fractures. Results: Among 5,230 potential reports 9 observational longitudinal studies provided data on the association between nocturia and falls or fractures (1 for both, 4 for falls, 4 for fractures). Pooled estimates demonstrated a risk ratio of 1.20 (95% CI 1.05-1.37, I-2 = 51.7%, annual risk difference 7.5% among the elderly) for association between nocturia and falls and 1.32 (95% CI 0.99-1.76, I-2 = 57.5%, annual risk difference 1.2%) for association between nocturia and fractures. Subgroup analyses showed no significant effect modification by age, gender, followup time, nocturia case definition or risk of bias. We rated the quality of evidence for nocturia as a prognostic factor as moderate for falls and low for fractures, and as very low as a cause of falls/fractures. Conclusions: Nocturia is probably associated with an approximately 1.2-fold increased risk of falls and possibly an approximately 1.3-fold increased risk of fractures.
Subject: accidental falls
fractures, bone
meta-analysis
nocturia
systematic review
URINARY-TRACT SYMPTOMS
BODY-MASS INDEX
INCIDENT FALLS
RISK
ASSOCIATION
MEN
INJURIES
QUALITY
GRADE
BIAS
3126 Surgery, anesthesiology, intensive care, radiology
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