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年龄校正的查尔森合并症指数评分作为接受手术切除的结直肠癌患者术后肠梗阻延长的预测指标。

Age-adjusted charlson comorbidity index score as predictor of prolonged postoperative ileus in patients with colorectal cancer who underwent surgical resection.

作者信息

Tian Yaohua, Xu Beibei, Yu Guopei, Li Yan, Liu Hui

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 100191 Beijing, China.

Medical Informatics Center, Peking University, 100191 Beijing, China.

出版信息

Oncotarget. 2017 Mar 28;8(13):20794-20801. doi: 10.18632/oncotarget.15285.

Abstract

Comorbidities had considerable effects on the development of postoperative ileus (POI). The primary aim of the present study was to determine the influence of the age-adjusted Charlson comorbidity index (ACCI) score on the risk of prolonged POI in patients with colorectal cancer who underwent surgical resection. Using the electronic Hospitalization Summary Reports, we identified 11,397 patients with colorectal cancer who underwent surgical resection from 2013 through 2015. Logistic regression models were applied to evaluate the effect of the ACCI score on the risk of prolonged POI. The ACCI score had a positive graded association with the risk of prolonged POI in both colon and rectal cancer (P for trend < 0.05). Among patients with rectal cancer, after adjusting for potential confounders, those with an ACCI score of 4-5 had a 108% higher risk of prolonged POI than those with an ACCI score of 0-1 (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.09-3.98), and those with an ACCI score of ≥ 6 had a 130% higher risk (OR, 2.30; 95% CI, 1.08-4.89). Among patients with colon cancer, those with an ACCI score of ≥ 6 had a 47% greater risk of prolonged POI than those with an ACCI score of 0-1 (OR, 1.47; 95% CI, 1.07-2.02). These findings suggested that a higher ACCI score was an independent predictor of the development of prolonged POI.

摘要

合并症对术后肠梗阻(POI)的发生有相当大的影响。本研究的主要目的是确定年龄校正的Charlson合并症指数(ACCI)评分对接受手术切除的结直肠癌患者发生持续性POI风险的影响。利用电子住院总结报告,我们确定了2013年至2015年间11397例接受手术切除的结直肠癌患者。应用逻辑回归模型评估ACCI评分对持续性POI风险的影响。ACCI评分与结肠癌和直肠癌持续性POI风险呈正分级关联(趋势P<0.05)。在直肠癌患者中,在调整潜在混杂因素后,ACCI评分为4-5的患者发生持续性POI的风险比ACCI评分为0-1的患者高108%(比值比[OR],2.08;95%置信区间[CI],1.09-3.98),ACCI评分≥6的患者风险高130%(OR,2.30;95%CI,1.08-4.89)。在结肠癌患者中,ACCI评分≥6的患者发生持续性POI的风险比ACCI评分为0-1的患者高47%(OR,1.47;95%CI,1.07-2.02)。这些发现表明,较高的ACCI评分是持续性POI发生的独立预测因素。

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