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中国结直肠癌患者行结直肠手术时的合并症与吻合口漏风险

Comorbidity and the risk of anastomotic leak in Chinese patients with colorectal cancer undergoing colorectal surgery.

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, No.38 Xueyuan Road, Beijing, 100191, China.

Medical Informatics Center, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.

出版信息

Int J Colorectal Dis. 2017 Jul;32(7):947-953. doi: 10.1007/s00384-017-2798-4. Epub 2017 Mar 23.

Abstract

PURPOSE

Comorbidities had considerable effects on the prognosis in patients with colorectal cancer (CRC). The primary aim of the present study was to examine the influence of comorbidity on the risk of anastomotic leak (AL) in patients with CRC who underwent surgical resection.

METHODS

Using the electronic Hospitalization Summary Reports in the top-ranked public hospitals in China, we identified 11,397 patients with CRC undergoing resection surgery from 2013 through 2015. We estimated the risk of AL according to Charlson Comorbidity Index (CCI) score using logistic regression analysis, adjusting for age, sex, and geographic regions.

RESULTS

The incidence rate of AL in the study population was 1.8% (204/11,397). Multivariable analyses identified male sex and CCI score as independent risk factors for AL. The CCI score had a positive graded association with the risk of AL (P for trend = 0.006). The risk increased by an estimated 10.2% (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.03-1.18) for each additional 1 point in the CCI score. After adjusting for potential confounders, patients with a CCI score ≥3 had 1.82 times (95% CI, 1.24-2.69) higher risk of AL compared with patients with a CCI score of 0.

CONCLUSION

The findings suggested that CCI score was an independent risk factor for the development of AL in Chinese patients with CRC who underwent surgical resection.

摘要

目的

合并症对结直肠癌(CRC)患者的预后有相当大的影响。本研究的主要目的是探讨合并症对接受手术切除的CRC患者吻合口漏(AL)风险的影响。

方法

利用中国排名靠前的公立医院的电子住院总结报告,我们确定了2013年至2015年期间11397例接受切除手术的CRC患者。我们使用逻辑回归分析,根据Charlson合并症指数(CCI)评分估计AL风险,并对年龄、性别和地理区域进行了调整。

结果

研究人群中AL的发生率为1.8%(204/11397)。多变量分析确定男性性别和CCI评分是AL的独立危险因素。CCI评分与AL风险呈正分级关联(趋势P=0.006)。CCI评分每增加1分,风险估计增加10.2%(优势比[OR],1.10;95%置信区间[CI],1.03-1.18)。在调整潜在混杂因素后,CCI评分≥3的患者发生AL的风险是CCI评分为0的患者的1.82倍(95%CI,1.24-2.69)。

结论

研究结果表明,CCI评分是接受手术切除的中国CRC患者发生AL的独立危险因素。

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