上部胃肠道癌症:死亡地点的趋势和决定因素
Zayed Rashid1, Mujtaba Khalil2, Muhammad Muntazir Mehdi Khan3
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH. Electronic address: https://twitter.com/ZRashidMD.
Surgery
|September 19, 2024
概括
健康的社会决定因素显著影响上部胃肠道癌症患者的死亡,与住院病人的死亡相关的较高脆弱性. 这些因素间接地推动了终身护理地点的基于种族的差异.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 社会学 社会学 社会学
背景情况:
- 上部胃肠道癌症需要全面的终身护理.
- 研究健康的社会决定因素 (SDOH) 对于理解终身护理差异至关重要.
研究的目的:
- 检查SDOH和上部胃肠道癌症患者死亡位置之间的关联.
- 根据社会脆弱性和种族,识别终身护理机构的差异.
主要方法:
- 利用广范围的流行病学研究在线数据 (WONDER) 数据库来获取患者数据 (2003-2020).
- 使用社会脆弱性指数 (SVI) 评估SDOH.
- 采用多变量回归和调解分析来确定患者特征,SDOH和死亡地点 (家庭,医院,临终关怀等) 之间的关联. ) 的情况.
主要成果:
- 分析了超过815,000名死者;大多数是55-74岁的白人男性.
- 在研究期间,死亡的主要地点从住院医院转移到家庭.
- 较高的社会脆弱性指数得分与在住院医院比在家中死亡的可能性增加有关.
- 黑人种族和更高的社会脆弱性独立地与在家死亡的几率较低有关.
- 65%的基于种族的相关性与住院病人的死亡是由SDOH调解的.
结论:
- 健康的社会决定因素是癌症患者终身护理地点的重要驱动因素.
- SDOH影响了上胃肠道癌症患者在家中死亡的可能性,突出了护理差异.
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