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选择性多学科肿瘤委员会会议对胃肠道癌患者死亡率的影响:一项回顾性观察研究。

Impact of optional multidisciplinary tumor board meeting on the mortality of patients with gastrointestinal cancer: A retrospective observational study.

机构信息

Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

出版信息

Cancer Rep (Hoboken). 2021 Aug;4(4):e1373. doi: 10.1002/cnr2.1373. Epub 2021 Mar 19.

Abstract

BACKGROUND

Multidisciplinary tumor board meetings (MDTs) have shown a positive effect on patient care and play a role in the planning of care. However, there is limited evidence of the association between MDTs and patient mortality and in-hospital morbidity for mixed cases of gastrointestinal (GI) cancer.

AIM

To evaluate the influence of optional MDTs on care of patients with cancer to determine potential associations between MDTs and patient mortality and morbidity.

METHODS AND RESULTS

This was a retrospective observational study at the referral center of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Among all adult patients diagnosed with GI cancer from January 2017 to June 2019, 130 patients were included. We categorized patients into two groups: 66 in the control group (non-MDT) and 64 in the MDT group. The main outcome measure was overall mortality, measured by survival analysis. The follow-up was 100% complete. Four patients in the MDT group and 13 in the non-MDT group died (P = .04). The median follow-up duration was 294 days (interquartile range [IQR], 140-434) in the non-MDT group compared with 176 days (IQR, 103-466) in the MDT group (P = .20). There were no differences in intensive care unit or hospital length-of-stay or admission rates. The overall mortality at 2 years was 13% (95% confidence interval [CI], 0.06-0.66) in the MDT group and 38% (95% CI, 0.10-0.39) in the non-MDT group (P = .08). The MDT group showed a 72% (adjusted hazard ratio [HR], 0.28; 95% CI, 0.08-0.90; P = .03) decrease in mortality over time compared with the non-MDT group.

CONCLUSIONS

MDTs were associated with decreased mortality over time. Thus, MDTs have a positive influence on patient care by improving survival and should be incorporated into care.

摘要

背景

多学科肿瘤委员会会议(MDT)已显示出对患者护理的积极影响,并在护理计划中发挥作用。然而,对于混合胃肠道(GI)癌症病例,MDT 与患者死亡率和住院发病率之间的关联证据有限。

目的

评估可选 MDT 对癌症患者护理的影响,以确定 MDT 与患者死亡率和发病率之间的潜在关联。

方法和结果

这是在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院的转诊中心进行的回顾性观察性研究。在 2017 年 1 月至 2019 年 6 月期间诊断为 GI 癌症的所有成年患者中,纳入了 130 名患者。我们将患者分为两组:对照组(非 MDT)66 例,MDT 组 64 例。主要观察指标为总死亡率,通过生存分析进行测量。随访率为 100%。MDT 组有 4 例患者死亡,非 MDT 组有 13 例患者死亡(P=.04)。非 MDT 组的中位随访时间为 294 天(四分位距[IQR],140-434),而 MDT 组为 176 天(IQR,103-466)(P=.20)。两组在重症监护病房或住院时间或入院率方面没有差异。MDT 组 2 年总死亡率为 13%(95%置信区间[CI],0.06-0.66),非 MDT 组为 38%(95% CI,0.10-0.39)(P=.08)。与非 MDT 组相比,MDT 组的死亡率随着时间的推移降低了 72%(调整后的风险比[HR],0.28;95%CI,0.08-0.90;P=.03)。

结论

MDT 与死亡率的降低有关。因此,MDT 通过提高生存率对患者护理产生积极影响,应纳入护理中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7af4/8388160/305a46dba757/CNR2-4-e1373-g001.jpg

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