Akinyemiju Tomi, Sakhuja Swati, Vin-Raviv Neomi
Department of Epidemiology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL, 35294-0022, USA.
Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Obes Surg. 2018 Mar;28(3):683-692. doi: 10.1007/s11695-017-2900-6.
Metabolic syndrome (MetS) is an important etiologic and prognostic factor for cancer, but few studies have assessed hospitalization outcomes among patients with both conditions.
Data was obtained from the Healthcare Cost and Utilization project Nationwide Inpatient Sample (HCUP-NIS). Study variables were assessed using ICD-9 codes on adults aged 40 years and over admitted to a US hospital between 2007 and 2011 with primary diagnosis of either breast, colorectal, or prostate cancer. We examined in-hospital mortality, post-surgical complications, and discharge disposition among cancer patients with MetS and compared with non-MetS patients.
Hospitalized breast (OR: 0.31, 95% CI: 0.20-0.46), colorectal (OR: 0.41, 95% CI: 0.35-0.49), and prostate (OR: 0.28, 95% CI: 0.16-0.49) cancer patients with MetS had significantly reduced odds of in-hospital mortality. The odds of post-surgical complications among breast (OR: 1.20, 95% CI: 1.03-1.39) and prostate (OR: 1.22, 95% CI: 1.09-1.37) cancer patients with MetS were higher, but lower by 7% among colorectal cancer patients with MetS. Additionally, breast (OR: 1.21, 95% CI: 1.11-1.32) and colorectal (OR: 1.06, 95% CI: 1.01-1.11) cancer patients with MetS had significantly higher odds for discharge to a skilled nursing facility compared with those without MetS, but this was not statistically significant among prostate cancer patients.
Adverse health outcomes were significantly higher among hospitalized patients with a primary diagnosis of cancer and MetS. Future studies are needed to identify clinical strategies for detecting and managing patients with MetS to reduce the likelihood of poor inpatient outcomes.
代谢综合征(MetS)是癌症的一个重要病因和预后因素,但很少有研究评估同时患有这两种疾病的患者的住院结局。
数据来自医疗成本和利用项目全国住院患者样本(HCUP-NIS)。使用国际疾病分类第九版(ICD-9)编码对2007年至2011年间在美国医院住院的40岁及以上成年人进行研究变量评估,这些患者的主要诊断为乳腺癌、结直肠癌或前列腺癌。我们检查了患有MetS的癌症患者的住院死亡率、术后并发症和出院处置情况,并与未患MetS的患者进行了比较。
患有MetS的住院乳腺癌(比值比:0.31,95%置信区间:0.20-0.46)、结直肠癌(比值比:0.41,95%置信区间:0.35-0.49)和前列腺癌(比值比:0.28,95%置信区间:0.16-0.49)患者的住院死亡率显著降低。患有MetS的乳腺癌(比值比:1.20,95%置信区间:1.03-1.39)和前列腺癌(比值比:1.22,95%置信区间:1.09-1.37)患者术后并发症的几率较高,但患有MetS的结直肠癌患者术后并发症的几率低7%。此外,与未患MetS的患者相比,患有MetS的乳腺癌(比值比:1.21,95%置信区间:1.11-1.32)和结直肠癌(比值比:1.06,95%置信区间:1.01-1.11)患者出院到专业护理机构的几率显著更高,但在前列腺癌患者中这一差异无统计学意义。
主要诊断为癌症且患有MetS的住院患者的不良健康结局显著更高。未来需要开展研究以确定检测和管理患有MetS的患者的临床策略,以降低住院结局不佳的可能性。