Skov Dalgaard Karoline, Gammelager Henrik, Sværke Claus, Kurics Tamás, Cetin Karynsa, Christiansen Christian Fynbo
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA.
Clin Epidemiol. 2015 Aug 13;7:363-8. doi: 10.2147/CLEP.S78301. eCollection 2015.
Skeletal-related events (SREs) among patients with bone metastases from lung cancer may be associated with considerable use of health care resources. We analyzed in- and outpatient hospital contacts in relation to SREs among all Danish lung cancer patients with bone metastases.
For this cohort study, we used the Danish Cancer Registry and the Danish National Registry of Patients to identify all persons diagnosed with first-time lung cancer and bone metastases from 2003 through 2009 in Denmark. We followed these patients until December 31, 2010, for the development of SREs (spinal cord compression; pathological or osteoporotic fracture, surgery to bone; or conventional external radiation therapy). We examined the number of inpatient hospitalizations, inpatient bed-days, hospital outpatient clinic visits, and emergency room visits within three time periods: a pre-SRE period (90-day period prior to the diagnostic period), a SRE diagnostic period (14-day period prior to the SRE), and a post-SRE period (90-day period after the SRE).
We identified 1,146 patients with lung cancer, bone metastases, and ≥1 subsequent SRE among 28,443 patients with incident lung cancer. Over 75% of patients with SREs (n=852) had more than one SRE. The number of hospital bed-days was high in the post-SRE period compared to the pre-SRE period, as illustrated by patients with multiple SREs who had 10.7 (95% confidence interval, 10.4-10.9) hospital bed-days per 100 person-days in the pre-SRE period and 28.2 (95% confidence interval, 27.8-28.6) bed-days per 100 person-days in the post-SRE period.
SREs secondary to bone metastases in lung cancer patients are associated with a substantial number of hospital contacts and hospital bed-days.
肺癌骨转移患者的骨相关事件（SREs）可能与大量医疗资源的使用有关。我们分析了丹麦所有肺癌骨转移患者中与SREs相关的住院和门诊情况。
在这项队列研究中，我们利用丹麦癌症登记处和丹麦国家患者登记处，确定了2003年至2009年在丹麦首次诊断为肺癌和骨转移的所有患者。我们对这些患者进行随访，直至2010年12月31日，观察SREs（脊髓压迫；病理性或骨质疏松性骨折、骨手术；或传统外照射治疗）的发生情况。我们在三个时间段内检查了住院次数、住院天数、医院门诊就诊次数和急诊就诊次数：SREs前期（诊断期前90天）、SREs诊断期（SREs前14天）和SREs后期（SREs后90天）。
在28443例新发肺癌患者中，我们确定了1146例患有肺癌、骨转移且至少发生1次后续SREs的患者。超过75%的SREs患者（n = 852）发生了不止一次SREs。与SREs前期相比，SREs后期的住院天数较多，例如，发生多次SREs的患者在SREs前期每100人日的住院天数为10.7（95%置信区间，10.4 - 10.9），在SREs后期每100人日的住院天数为28.2（95%置信区间，27.8 - 28.6）。
肺癌患者骨转移继发的SREs与大量的医院接触和住院天数相关。
