Arthur Susan T, Van Doren Bryce A, Roy Debosree, Noone Joshua M, Zacherle Emily, Blanchette Christopher M
a University of North Carolina at Charlotte , Charlotte , NC , USA.
J Med Econ. 2016 Sep;19(9):874-80. doi: 10.1080/13696998.2016.1181640. Epub 2016 May 11.
Cancer cachexia is a debilitating condition and results in poor prognosis. The purpose of this study was to assess hospitalization incidence, patient characteristics, and medical cost and burden of cancer cachexia in the US.
This study used a cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for 2009. Five cancers reported to have the highest cachexia incidence were assessed. The hospitalization incidence related to cachexia was estimated by cancer type, cost and length of stay were compared, and descriptive statistics were reported for each cancer type, as well as differences being compared between patients with and without cachexia.
Risk of inpatient death was higher for patients with cachexia in lung cancer (OR = 1.32; CI = 1.20-1.46) and in all cancers combined (OR = 1.76; CI = 1.67-1.85). The presence of cachexia increased length of stay in lung (IRR = 1.05; CI = 1.03-1.08), Kaposi's sarcoma (IRR = 1.47; CI = 1.14-1.89) and all cancers combined (IRR = 1.09; CI = 1.08-1.10). Additionally, cachectic patients in the composite category had a longer hospitalization stay compared to non-cachectic patients (3-9 days for those with cachexia and 2-7 days for those without cachexia). The cost of inpatient stay was significantly higher in cachexic than non-cachexic lung cancer patients ($13,560 vs $13 190; p < 0.0001), as well as cachexic vs non-cachexic cancer patients in general (14 751 vs 13 928; p < 0.0001).
Cachexia increases hospitalization costs and length of stay in several cancer types. Identifying the medical burden associated with cancer cachexia will assist in developing an international consensus for recognition and coding by the medical community and ultimately an effective treatment plans for cancer cachexia.
癌症恶病质是一种使人衰弱的病症，会导致预后不良。本研究的目的是评估美国癌症恶病质的住院发病率、患者特征以及医疗成本和负担。
本研究对2009年全国住院患者样本（NIS）进行了横断面分析。评估了报告恶病质发病率最高的五种癌症。按癌症类型估计与恶病质相关的住院发病率，比较成本和住院时间，并报告每种癌症类型的描述性统计数据，以及比较有恶病质和无恶病质患者之间的差异。
肺癌（OR = 1.32；CI = 1.20 - 1.46）以及所有癌症合并（OR = 1.76；CI = 1.67 - 1.85）时，恶病质患者的住院死亡风险更高。恶病质的存在增加了肺癌（IRR = 1.05；CI = 1.03 - 1.08）、卡波西肉瘤（IRR = 1.47；CI = 1.14 - 1.89）以及所有癌症合并（IRR = 1.09；CI = 1.08 - 1.10）的住院时间。此外，综合类别中的恶病质患者比无恶病质患者的住院时间更长（恶病质患者为3 - 9天，无恶病质患者为2 - 7天）。恶病质肺癌患者的住院成本显著高于无恶病质肺癌患者（13,560美元对13,190美元；p < 0.0001），总体上恶病质癌症患者与无恶病质癌症患者相比也是如此（14,751美元对13,928美元；p < 0.0001）。
恶病质增加了几种癌症类型的住院成本和住院时间。确定与癌症恶病质相关的医疗负担将有助于医学界就识别和编码达成国际共识，并最终制定出有效的癌症恶病质治疗方案。
