Department of Medical Sciences, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Italy.
Eur Rev Med Pharmacol Sci. 2018 Apr;22(8):2266-2272. doi: 10.26355/eurrev_201804_14814.
The aim of this retrospective study was to investigate the relationship between cancer, non-immunologic comorbidity, estimated by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codification, gender and in-hospital mortality (IHM) in a large sample of renal transplant recipients (RTRs) living in the region Emilia-Romagna (RER) of Italy.
We evaluated IHM in RTRs admitted between 2000 and 2013 recorded in the RER database. By using ICD-9-CM codes, the Elixhauser index (EI) was calculated, and cancers were identified and classified as skin cancers (SC), solid organ cancers (SOC) and post-transplant lymphoproliferative disorders (PTLD). IHM was the dependent variable of the multivariate models, while age, gender, EI corrected removing the effect of malignancies (cEI), and different types of cancer were the independent ones.
During the examined period, a total of 9,063 admissions in 3,648 RTRs were recorded, of whom 117 died (3.2%). The mean age was 52.9±13.1 years. Cancers were reported in 580 admissions (6.4%), and mean cEI was 3.5±3.4. Deceased RTRs were older, had a higher prevalence of PTLD and SOC, and had a higher cEI than survivors. IHM was independently associated with (in decreasing order) PTLD (OR 12.431, 95%CI 5.834-26.489, p<0.001), SOC (OR 6.804, 95%CI 4.323-10.707, p<0.001), female gender (OR 1.633, 95%CI 1.057-2.523, p=0.006), cEI (OR 1.106, 95%CI 1.068-1.145, p<0.001), and age (OR 1.049, 95%CI 1.031-1.068, p<0.001) CONCLUSIONS: Cancer, in particular SOC and PTLD, is strongly associated with IHM in RTRs. On the other hand, rather surprisingly, female gender exhibited a stronger association with IHM than other more expected factors, such as comorbidity and age.
本回顾性研究旨在探讨癌症与非免疫合并症（通过国际疾病分类，第 9 版临床修订版[ICD-9-CM]编码评估）、性别与意大利艾米利亚-罗马涅地区（RER）大型肾移植受者（RTR）院内死亡率（IHM）之间的关系。
我们评估了 2000 年至 2013 年期间在 RER 数据库中记录的 RTR 住院患者的 IHM。通过使用 ICD-9-CM 代码，计算了 Elixhauser 指数（EI），并识别和分类癌症为皮肤癌（SC）、实体器官癌（SOC）和移植后淋巴组织增生障碍（PTLD）。IHM 是多变量模型的因变量，而年龄、性别、去除恶性肿瘤影响后的 EI 校正值（cEI）和不同类型的癌症则是独立变量。
在所研究期间，在 3648 名 RTR 中，共记录了 9063 次入院，其中 117 人死亡（3.2%）。平均年龄为 52.9±13.1 岁。580 次入院（6.4%）报告了癌症，平均 cEI 为 3.5±3.4。与幸存者相比，死亡的 RTR 年龄更大，PTLD 和 SOC 的患病率更高，cEI 也更高。IHM 与（按降序排列）PTLD（OR 12.431，95%CI 5.834-26.489，p<0.001）、SOC（OR 6.804，95%CI 4.323-10.707，p<0.001）、女性（OR 1.633，95%CI 1.057-2.523，p=0.006）、cEI（OR 1.106，95%CI 1.068-1.145，p<0.001）和年龄（OR 1.049，95%CI 1.031-1.068，p<0.001）独立相关。
癌症，特别是 SOC 和 PTLD，与 RTR 的 IHM 密切相关。另一方面，令人惊讶的是，与其他更预期的因素（如合并症和年龄）相比，女性性别与 IHM 的关联更强。
