title: Underweight body mass index is a risk factor of mortality in outpatients with nocturia in Japan.
abstract: BACKGROUND
  Although nocturia has been reported to increase mortality in elderly individuals, the particular risk factors that are associated with this event are unclear. Therefore, we evaluated risk factors for death in outpatients with nocturia.
  
  
  METHODS
  Between October 2002 and December 2009, 250 consecutive patients with nocturia were enrolled in two general hospitals in Japan. Among them, 193 patients were able to be followed for at least 1 year and up to 9 years (median 4.8 years) if the patients did not die. Mortality rates and risk factors were evaluated in the nocturic outpatients.
  
  
  RESULTS
  Two- and 5-year survival of the nocturic outpatients was 94.6% [95% confidence interval (CI) = 92.2-97.1] and 82.6% (95% CI = 75.4-87.8), respectively. Higher Charlson Comorbidity Score, lower body mass index (BMI) and lower Physical Component Summary of Short Form-36 item scores were significantly correlated with mortality (p < 0.0001, p < 0.005 and p < 0.05, respectively) in multivariate analysis. The International Prostate Symptom Score, Pittsburgh Sleep Quality Index, Mental or Role/Social Component Summary of Short Form-36 item scores and Nocturnal Polyuria index were not significantly correlated with mortality. The mortality rate was significantly higher in subjects with an underweight BMI (<18.50) compared with a normal range (18.50-24.99) or overweight (≥25.00) BMI [p < 0.00005, hazard ratio (HR) = 5.84, 95% CI = 2.03-16.8; p < 0.0005, HR = 5.92, 95% CI = 1.94-18.0].
  
  
  CONCLUSIONS
  Additional attention is required for nocturic outpatients with not only a high Charlson Comorbidity Score but also an underweight BMI because of their high mortality. Large prospective studies are warranted to validate this finding and extend more.
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. hnegoro@kuhp.kyoto-u.ac.jp.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Negoro
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. suginoy@kcho.jp.|Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan. suginoy@kcho.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sugino
authors.affiliation: Department of Urology, Kurashiki Central Hospital, Okayama, Japan. nishizaw@kuhp.kyoto-u.ac.jp.|Department of Urology, Shiga Medical Center for Adults, Shiga, Japan. nishizaw@kuhp.kyoto-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Nishizawa
authors.affiliation: Department of Urology, Kurashiki Central Hospital, Okayama, Japan. sodatakeshi@gmail.com.|Department of Urology, Kitano Hospital, Osaka, Japan. sodatakeshi@gmail.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soda
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. yousuke@kuhp.kyoto-u.ac.jp.|Department of Urology, West Kobe Medical Center, Kobe, Japan. yousuke@kuhp.kyoto-u.ac.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan. keyoshim@med.kobe-u.ac.jp.|Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan. keyoshim@med.kobe-u.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yoshimura
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. ogawao@kuhp.kyoto-u.ac.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. ky7527@kuhp.kyoto-u.ac.jp.|Department of Urology, Shizuoka General Hospital, 4-27-1 Kita Ando, Shizuoka Aoi-ku, Shizuoka, Japan. ky7527@kuhp.kyoto-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D053158:Nocturia / Q000453:epidemiology* / Q000401:mortality*; D010045:Outpatients; D016016:Proportional Hazards Models; D012307:Risk Factors; D013851:Thinness / Q000150:complications*