通过任何其他名字:癌症和其预测因素在行政数据库中的癌症和其预测因素的肠道切除术后肠道功能障碍
Ira L Leeds1, Nathan A Coppersmith1, Miranda S Moore1
1Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
The Journal of surgical research
|October 16, 2024
概括
肠道功能障碍影响了近40%的癌症前切除患者,化疗增加了风险. 这种情况大大增加了手术后医疗保健成本的两倍.
科学领域:
- 结肠直肠手术的结果
- 胃肠道瘤学 胃肠道瘤学
- 医疗服务研究 医疗服务研究
背景情况:
- 癌症前科切除术后肠道功能障碍在人口研究中了解得很少.
- 缺乏特定的行政法规,阻碍了低前切除综合征的分析.
- 这项研究旨在定义和分析索赔数据中的肠功能障碍表型.
研究的目的:
- 在行政索赔数据中确定肠道功能障碍的表型.
- 描述肠道切除术后肠功能障碍的患病率和预测因素.
- 评估与肠道功能障碍相关的医疗保健成本.
主要方法:
- 使用雇主赞助的保险索赔 (MarketScan) 的回顾性队列研究.
- 在手术后18个月内通过腹,便秘或失禁的诊断代码来定义肠道功能障碍.
- 使用波桑回归来确定预测因素并比较医疗保健成本.
主要成果:
- 在2131名癌症直肠切除术患者中,39.7%的患者在18个月内出现了肠道功能障碍.
- 便秘 (53.5%) 和腹 (40.3%) 是最常见的;诊断/康复程序未得到充分利用 (29.8%).
- 新辅助化疗 (有或没有辐射) 预测了功能障碍;受影响患者的中位成本高出30,769美元 (P < 0.001).
结论:
- 超过三分之一的患者在直肠切除术后18个月内出现症状性肠功能障碍.
- 多剂化疗是术后肠道功能障碍最强的预测因素.
- 肠道功能障碍使术后医疗保健费用增加了一倍以上.
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