Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Road, Nanjing, Jiangsu, China.
Int J Cardiol. 2018 Nov 1;270:287-292. doi: 10.1016/j.ijcard.2018.06.054. Epub 2018 Jun 18.
To investigate risk factors contributing to early death in patients diagnosed with primary malignant cardiac tumors (PMCTs) and derive better understanding of these poorly characterized individuals.
Data from the Surveillance, Epidemiology and End-Results (SEER) registries on 564 patients diagnosed with PMCTs between 1973 and 2014 were analyzed. Early death was defined as survival of ≤3 months from the time of diagnosis. Two-tailed χ or fisher's exact test were used for association between categorical variables and occurrence of early death. Logistic regression analysis was used to assess independent risk factors of early death. Time trends in early death rates of PMCTs were described using scatter plot.
Of the 564 patients with PMCTs, early death was identified in 214 individuals (37.9%). Patients with unspecified soft tissue sarcomas and blood vessel tumors had the highest risk of early death. Age > 80 years and non-consent for surgery were strong predictors of early death in all PMCT subtypes. In sarcomas, disadvantaged income was associated with an increase in early mortality, while black race was associated with a reduction in early mortality. In mesotheliomas and others, male sex was a risk factor for early mortality, while Hispanic ethnicity was associated with a reduction in early mortality. Percentages of early death slightly decreased over the past 40 years.
Predictors of early death are primarily related to age older than 80 years, no surgery and specific histopathology types but also include disadvantaged socioeconomic status and male sex. Initiatives to identify those at risk and develop preventive interventions should be prioritized.
探究导致原发性心脏恶性肿瘤（PMCT）患者早期死亡的风险因素，以便更好地了解这些特征不明确的患者。
对 1973 年至 2014 年间，来自监测、流行病学和最终结果（SEER）数据库的 564 例 PMCT 患者的数据进行分析。早期死亡定义为从诊断时起生存时间≤3 个月。采用双侧 χ2 检验或 Fisher 确切概率法分析分类变量与早期死亡发生之间的关系。采用 logistic 回归分析评估早期死亡的独立危险因素。采用散点图描述 PMCT 早期死亡率的时间趋势。
在 564 例 PMCT 患者中，214 例（37.9%）患者发生早期死亡。未特指的软组织肉瘤和血管肿瘤患者具有最高的早期死亡风险。年龄>80 岁和不同意手术是所有 PMCT 亚型早期死亡的强烈预测因素。在肉瘤中，低收入与早期死亡率增加相关，而黑种人则与早期死亡率降低相关。在间皮瘤和其他肿瘤中，男性是早期死亡率的危险因素，而西班牙裔与早期死亡率降低相关。在过去的 40 年中，早期死亡率的百分比略有下降。
早期死亡的预测因素主要与 80 岁以上的年龄、无手术和特定的组织病理学类型相关，但也包括社会经济地位较低和男性性别。应优先确定高危人群并制定预防干预措施。
