Hall Stephen F, Rochon Paula A, Streiner David L, Paszat Lawrence F, Groome Patti A, Rohland Susan L
Department of Otolaryngology, Queen's University, Kingston, Ontario, Canada.
Laryngoscope. 2002 Nov;112(11):1988-96. doi: 10.1097/00005537-200211000-00015.
Comorbidities are diseases or conditions that coexist with a disease of interest. The importance of comorbidities is that they can alter treatment decisions, change resource utilization, and confound the results of survival analysis.
The objective of this study was to determine the best comorbidity index to use in survival analysis of patients with squamous cell carcinoma of the head and neck.
Four validated indexes, with very different methodologies (i.e., the Charlson Index, the Cumulative Illness Rating Scale, the Kaplan-Feinstein Classification, the Index of Co-existent Disease), were tested using data from 379 unselected consecutive patients with complete 3-year follow-up from the Kingston Regional Cancer Center. Kaplan-Meier analysis and Cox Proportional Hazards Regression were used to stratify patients into three levels of increasing severity of comorbidity for each index. The Proportion of Variance Explained and Receiver Operating Characteristics curves were used to compare the performance of the indexes.
The Kaplan-Feinstein Classification was the most successful in stratifying patients in this population.
合并症是与所关注疾病同时存在的疾病或状况。合并症的重要性在于它们会改变治疗决策、改变资源利用情况并混淆生存分析的结果。
本研究的目的是确定在头颈部鳞状细胞癌患者生存分析中使用的最佳合并症指数。
使用来自金斯顿地区癌症中心的379例未经选择的连续患者的数据，对四种经过验证的指数（即查尔森指数、累积疾病评分量表、卡普兰-费因斯坦分类法、共存疾病指数）进行了测试，这些指数的方法差异很大。使用卡普兰-迈耶分析和考克斯比例风险回归将患者按每个指数分为合并症严重程度递增的三个级别。使用方差解释比例和受试者工作特征曲线来比较各指数的性能。
在对该人群患者进行分层方面，卡普兰-费因斯坦分类法最为成功。
