"谢谢,但没有谢谢":与拒绝为甲状腺癌进行手术的患者相关的因素
Catherine G Pratt1, Szu-Aun Long2, Jenna N Whitrock3
1Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, OH.
Surgery
|October 31, 2024
概括
许多患有差异化甲状腺癌的患者拒绝接受手术,这一决定与生存率下降有关. 诸如年龄较大,男性性别,少数民族种族和缺乏保险等因素增加了这种可能性.
科学领域:
- 在瘤学瘤学.
- 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:
- 手术是甲状腺癌的主要治疗方法.
- 越来越多的患者拒绝推的手术干预.
- 了解影响这种决定的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了确定患者的特征和社会经济因素与下降的手术与关联的不同类型的甲状腺癌.
- 分析下降的手术对整体存活时间的影响.
主要方法:
- 国家癌症数据库 (2004-2017) 的回顾性分析.
- 包括患有乳头或卵泡甲状腺癌的患者.
- 使用后勤回归和生存分析,对手术和非手术组之间的患者人口统计,临床因素,保险状况和生存率进行比较.
主要成果:
- 在221,664名患者中,0.3%的人拒绝接受手术.
- 拒绝手术的患者年龄较大,男性,黑人或亚洲人,没有保险,并具有更高的并发症得分和更大的瘤.
- 多变量分析确定了年龄较大,黑人/亚洲人种族,缺乏私人保险,以及晚期是下降手术的重要预测因素.
结论:
- 对差异化甲状腺癌的手术减少与总体存活率明显降低有关.
- 社会经济和人口因素在拒绝手术的决定中起着关键作用.
- 解决手术护理的障碍对于减少差异和改善弱势患者群体的结果至关重要.
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