多种疾病及其对美国老年退伍军人的影响,这些退伍军人最近接受了高级非小细胞肺癌的治疗
Joseph R Larsen1,2,3, Chunlei Zheng1,4, Jennifer La1,2
1Veterans Affairs Boston Cooperative Studies Program and.
Annals of the American Thoracic Society
|December 16, 2024
概括
患有晚期非小细胞肺癌 (NSCLC) 的老年人具有明显的多病态模式,影响生存. 识别这些模式对于了解这一群体的死亡率和医疗保健使用至关重要.
科学领域:
- 老年学是指老年学的学科.
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 年长的成年人构成了大多数高级非小细胞肺癌 (NSCLC) 患者.
- 多病症在这个人群中很常见,但由于标准指数的局限性和试验排除,人们对其影响知之甚少.
- 确定特定的多病态模式对于准确的风险评估至关重要.
研究的目的:
- 在美国老年退伍军人中识别和定义高级NSCLC的多病态模式.
- 确定这些模式与死亡率和医疗保健利用率的关联.
- 为了提供一个更细微的理解,超越简单的并发症计数.
主要方法:
- 在10160名退伍军人 (65岁) 中,对63种慢性疾病进行了潜在类别分析,这些退伍军人接受了高级NSCLC (2002-2020) 的治疗.
- 通过Kaplan-Meier和Cox的比例危险回归来评估与整体存活率,急诊室访问和住院的关联.
- 根据模型合适性和临床相关性确定的模式,控制人口统计和临床因素.
主要成果:
- 确定了五种不同的多病态模式.
- 与显著变化的整体存活率相关的模式 (日志等级P < 0.001).
- 代谢性疾病,精神病/物质使用障碍,心血管疾病和多系统损伤模式显示,与常见的衰老状况相比,死亡风险增加.
结论:
- 高龄退伍军人患有晚期NSCLC的慢性疾病聚集成不同的临床意义模式.
- 这些多病态模式的特异性提供了超越仅仅条件数量的预后价值.
- 这些模式独立地与死亡率和医疗保健使用相关,突出显示了它们的临床意义.
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