初级脊柱骨性恶性骨瘤的差异 医疗补助状态的生存率:基于全国人口的风险分析
Arjun Ganga1, Eric J Kim1, James Y Lee2
1Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
World neurosurgery
|September 30, 2023
概括
脊柱原发性恶性骨瘤 (sPMBT) 的医疗补助患者面临更糟糕的生存率,并且不太可能接受手术. 这些生存差异在少数群体中更为明显.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 医疗补助的地位对脊柱原发性恶性骨瘤 (sPMBT) 患者的生存的影响仍未得到研究.
- 了解癌症护理和治疗结果的差异对于改善患者存活率至关重要.
研究的目的:
- 调查诊断为sPMBT的成年患者的医疗补助状况和生存结果之间的关联.
- 根据保险状况确定导致sPMBT患者生存差异的因素.
主要方法:
- 利用SEER-Medicaid数据库分析2006年至2013年间被诊断患有sPMBT的成年患者.
- 使用Kaplan-Meier和Cox比例风险回归进行了五年生存分析,并调整了多个人口,临床和瘤相关的变量.
- 包括组织学,如冠状瘤,骨髓瘤,冠状瘤,尤宁肉瘤和恶性巨细胞瘤 (GCT).
主要成果:
- 确定了572名sPMBT患者;医疗补助患者年轻,更有可能是黑人,生活在贫困地区,在诊断时有远程转移.
- 与非医疗补助患者 (67.2%) (P=0.02) 相比,医疗补助患者的5年生存率明显较差 (52.0%).
- 接受医疗补助的少数群体患癌症的死亡率增加了2.51倍. 不接受手术和较大的瘤直径 (>50毫米) 与死亡风险增加有关.
结论:
- 患有sPMBT的医疗补助患者的生存结果较差,可能与接受手术治疗的可能性降低有关.
- 存在显著的生存差异,特别是在医疗补助人口中的少数群体患者中.
- 解决护理和治疗的机会,特别是手术,对于减轻脆弱患者群体的生存差距至关重要.
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