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社会经济因素对择期结直肠癌手术后30天死亡率的影响:一项全国性研究。

The impact of socioeconomic factors on 30-day mortality following elective colorectal cancer surgery: a nationwide study.

作者信息

Frederiksen B L, Osler M, Harling H, Ladelund Steen, Jørgensen T

机构信息

Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup University Hospital, Building 84/85, DK-2600 Glostrup, Denmark.

Institute of Public Health, Department of Social Medicine, University of Copenhagen, 1014 Copenhagen K, Denmark.

出版信息

Eur J Cancer. 2009 May;45(7):1248-1256. doi: 10.1016/j.ejca.2008.11.035. Epub 2009 Jan 10.

Abstract

We investigated postoperative mortality in relation to socioeconomic status (SES) in electively operated colorectal cancer patients, and evaluated whether social inequalities were explained by factors related to patient, disease or treatment. Data from the nationwide database of Danish Colorectal Cancer Group were linked to individual socioeconomic information in Statistics Denmark. Patients born before 1921 and those having local surgical or palliative procedures were excluded. A total of 7160 patients, operated on in the period 2001-2004, were included, of whom 342 (4.8%) died within 30 days of surgery. Postoperative mortality was significantly lower in patients with high income (odds ratio (OR)=0.82 (0.70-0.95) for each increase in annual income of EUR 13,500), higher education versus short education (OR)=0.60 (0.41-0.87), and owner-occupied versus rental housing (OR)=0.73 (0.58-0.93). Differences in comorbidity and to a lesser extent lifestyle characteristics accounted for the excess risk of postoperative death among low-SES patients.

摘要

我们调查了择期接受手术的结直肠癌患者术后死亡率与社会经济地位(SES)之间的关系,并评估了社会不平等是否可由与患者、疾病或治疗相关的因素来解释。丹麦结直肠癌组全国数据库的数据与丹麦统计局的个人社会经济信息相关联。排除了1921年以前出生的患者以及接受局部手术或姑息手术的患者。总共纳入了2001年至2004年期间接受手术的7160例患者,其中342例(4.8%)在术后30天内死亡。高收入患者的术后死亡率显著较低(年收入每增加13,500欧元,优势比(OR)=0.82(0.70 - 0.95)),受过高等教育与受教育时间短的患者相比(OR)=0.60(0.41 - 0.87),自有住房与租赁住房的患者相比(OR)=0.73(0.58 - 0.93)。合并症差异以及在较小程度上生活方式特征解释了低社会经济地位患者术后死亡的额外风险。

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