在医院癌症登记册中,并发症的预后重要性
Jay F Piccirillo1, Ryan M Tierney, Irene Costas
1Department of Otolaryngology-Head and Neck Surgery, Washington University, St Louis, Mo 63110, USA. piccirij@msnotes.wustl.edu
JAMA
|May 27, 2004
概括
伴随性疾病显著影响癌症患者的存活率,无论癌症的阶段如何. 较高的并发症严重程度与更差的生存结果相关,突出其预后价值.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 癌症患者经常出现同时存在的医疗条件 (并发症).
- 伴随性疾病可以影响癌症治疗决策,患者预后和护理质量的评估.
研究的目的:
- 为了确定伴随性疾病数据是否在医院癌症注册表中提供了重要的预后见解.
- 评估各种癌症类型的并发症的预后价值.
主要方法:
- 采用了观察前性队列研究设计.
- 经过训练的癌症注册人员使用成年伴随性疾病评估27仪器系统地收集了伴随性疾病数据.
- 数据包括了17712名患者,在1995年至2001年期间被诊断患有前列腺,肺,乳腺,消化道,妇科,泌尿道或头癌.
主要成果:
- 伴随性疾病的严重程度表明,对总体存活率产生了剂量依赖的负面影响,无论癌症的阶段如何.
- 与没有并发症的患者相比,患有严重并发症的患者死亡率的调整后危险比率 (2.56) 显著更高.
- 调整后的生存分析证实,伴随性疾病严重程度的增加与较差的生存结果有关 (P<.001).
结论:
- 伴随性疾病是癌症患者的关键,独立的预后因素.
- 将并发症数据整合到癌症登记册中,提高了观察性癌症研究的实用性和价值.
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