手术质量与肺癌的长期存活率之间的关联
James D Lee1, Richard Zheng2, Olugbenga T Okusanya3
1Division of Pulmonary, Allergy, and Critical Care, Penn Presbyterian Medical Center, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Lung cancer (Amsterdam, Netherlands)
|February 28, 2024
概括
肺癌切除后90天的历史死亡率是长期生存的可靠指标. 历史死亡率较低的医院在肺癌患者中显示出更好的5年生存率,这凸显了术后结果在评估护理质量的重要性.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 肺癌切除后的术后和长期结果存在显著差异.
- 术后结果通常用于衡量护理质量,但其与长期存活的关联不清楚.
研究的目的:
- 评估肺癌切除后的历史外科手术期间死亡率是否与5年生存率有关.
主要方法:
- 利用国家癌症数据库 (NCDB) 对接受切除的非小细胞肺癌 (NSCLC) 患者 (2010-2016).
- 分析了医院级可靠性调整后的90天死亡率 (2010-2013),作为2014-2016年诊断的患者5年生存率的预测指标.
主要成果:
- 具有历史最佳90天死亡率 (最低四分位数) 的医院,与最差四分位数的医院相比,在所有阶段显示出明显更好的5年生存率.
- 这种关联在多变量考克斯回归和卡普兰-梅尔分析中对所有阶段和单个阶段 (I-III) 仍然显著.
结论:
- 术后结果,特别是90天死亡率的历史,可以有效地描述长期存活率,并反映肺癌切除治疗的更广泛的护理质量.
- 使用术后结果评估肺癌护理质量,可以有助于提供者绩效分析,并为基于价值的支付政策提供信息.
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