合并症对结直肠癌切除术后患者总生存及死亡原因的影响。
The impact of comorbidity on the overall survival and the cause of death in patients after colorectal cancer resection.
作者信息
Rieker Ralf Joachim, Hammer Eva, Eisele Roland, Schmid Eberhardt, Högel Josef
机构信息
Department of Pathology, Im Neuenheimer Feld 220/221, University of Heidelberg, Germany.
出版信息
Langenbecks Arch Surg. 2002 Jun;387(2):72-6. doi: 10.1007/s00423-002-0291-0. Epub 2002 Apr 30.
BACKGROUND
Retrospective investigation to identify associations between certain patient characteristics and survival in 531 patients with resected colorectal cancer (CRC). Special reference is given to a standardized comorbidity.
METHODS
To compare different levels of exposure we determined hazard ratios (HR) in Cox proportional hazards models for survival times and odds ratios (OR) in logistic regression models.
RESULTS
Overall survival was associated with tumor stages (III+IV vs. I+II; HR 7.48), tumor differentiation (low vs. high; HR 1.84), blood transfusions (>2 vs. < or =2; HR 1.88), and comorbidity (Charlson Comorbidity Index >2 vs. < or =2; HR 1.77). Low tumor stage (I+II vs. III+IV; OR 11.1), elevated Charlson Comorbidity Index (>2 vs. < or =2; OR 3.83), and longer ICU stay (>2 days vs. < or =2 days; OR 3.40) more frequently lead to non-cancer-related death than to cancer-related death.
CONCLUSION
Standardized comorbidity should be considered as a factor in survival studies of CRC.
背景
对531例接受结直肠癌（CRC）切除术患者的某些患者特征与生存率之间的关联进行回顾性调查。特别提及标准化合并症。
方法
为比较不同暴露水平，我们在Cox比例风险模型中确定生存时间的风险比（HR），在逻辑回归模型中确定比值比（OR）。
结果
总生存率与肿瘤分期（III + IV期 vs. I + II期；HR 7.48）、肿瘤分化程度（低分化 vs. 高分化；HR 1.84）、输血情况（>2次 vs. ≤2次；HR 1.88）以及合并症（Charlson合并症指数>2 vs. ≤2；HR 1.77）相关。低肿瘤分期（I + II期 vs. III + IV期；OR 11.1）、较高的Charlson合并症指数（>2 vs. ≤2；OR 3.83）以及较长的重症监护病房停留时间（>2天 vs. ≤2天；OR 3.40）导致非癌症相关死亡的频率高于癌症相关死亡。
结论
在CRC生存研究中应将标准化合并症视为一个因素。
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