Raval Amit D, Madhavan Suresh, Mattes Malcolm D, Salkini Mohamad, Sambamoorthi Usha
Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, West Virginia
Department of Radiation Oncology, School of Medicine, West Virginia University, Morgantown, West Virginia
J Natl Compr Canc Netw. 2016 Feb;14(2):186-94. doi: 10.6004/jnccn.2016.0022. Epub 2016 Feb 5.
The purpose of this study was to analyze the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods in a cohort of fee-for-service Medicare beneficiaries with incident prostate cancer.
A population-based retrospective cohort study was conducted using the SEER-Medicare linked database for 2000 through 2010. The study cohort consisted of 57,489 elderly men (aged ≥ 67 years) with incident prostate cancer. NCHs were identified in 6 periods (t1-t6) before and after the incidence of prostate cancer. Each period consisted of 120 days. For each period, NCHs were defined as inpatient admissions with primary diagnosis codes not related to prostate cancer, prostate cancer-related procedures, or bowel, sexual, and urinary dysfunction. Bivariate and multivariate comparisons on rates of NCHs between the precancer and postcancer periods accounted for the repeated measures design.
The rate of NCHs was higher during the postcancer period (5.1%) compared with the precancer period (3.2%). In both unadjusted and adjusted models, elderly men were 37% (odds ratio [OR], 1.37; 95% CI, 1.32, 1.41) and 38% (adjusted OR, 1.38; 95% CI, 1.33, 1.46) more likely to have any NCHs during the postcancer period compared with the precancer period.
Elderly men with prostate cancer had a significant increase in the risk of NCHs after the diagnosis of prostate cancer. This study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.
本研究的目的是通过比较一组按服务收费的医疗保险受益人群中前列腺癌患者癌前和癌后时期的非癌症住院情况，分析癌症诊断对非癌症住院（NCH）的影响。
利用2000年至2010年的SEER - 医疗保险链接数据库进行了一项基于人群的回顾性队列研究。研究队列包括57489名患有前列腺癌的老年男性（年龄≥67岁）。在前列腺癌发病前后的6个时期（t1 - t6）确定非癌症住院情况。每个时期为120天。对于每个时期，非癌症住院定义为主要诊断编码与前列腺癌、前列腺癌相关手术或肠道、性功能和排尿功能障碍无关的住院入院。癌前和癌后时期非癌症住院率的双变量和多变量比较考虑了重复测量设计。
癌后时期的非癌症住院率（5.1%）高于癌前时期（3.2%）。在未调整和调整模型中，与癌前时期相比，老年男性在癌后时期发生任何非癌症住院的可能性分别高37%（优势比[OR]，1.37；95%置信区间，1.32，1.41）和38%（调整后OR，1.38；95%置信区间，1.33，1.46）。
前列腺癌老年男性在诊断前列腺癌后非癌症住院风险显著增加。本研究强调需要设计干预措施以减少老年男性前列腺癌诊断后的非癌症住院超额情况。
