Unidad de Investigación, Hospital Galdakao-Usansolo, Barrio Labeaga s/n, 48960, Galdakao, Bizkaia, Spain.
Red de Investigación en Servicios Sanitarios Y Enfermedades Crónicas (REDISSEC), Galdakao, Spain.
J Gastrointest Cancer. 2023 Mar;54(1):20-26. doi: 10.1007/s12029-021-00779-8. Epub 2021 Dec 10.
Some quality indicators of proper health care in patients with colorectal cancer have been established.
Our goal was to evaluate the relationship between performing of certain procedures or treatments, included as quality indicators, and some outcomes of indicators in the follow-up of colorectal cancer patients.
This was a prospective cohort study of patients diagnosed with colorectal cancer that underwent surgery and were followed at 1, 2, 3, and 5 years. CT scanning, colonoscopy, chemotherapy, and radiotherapy were evaluated in relation to various clinical outcomes and PROM changes over 5 years. Multivariable generalized linear mixed models were used to evaluate their effect on mortality, complications, recurrence, and PROM changes (HAD, EQ-5D, EORTC-Q30) at the next follow-up.
CT scanning or colonoscopy was related to a decrease in the risk of dying, while chemotherapy at a specified moment was related to an increased risk. In the case of recurrence, CT scanning and chemotherapy showed statistically increased the risk, while all the procedures and treatments influenced complications. Regarding PROM scales, CT scanning, colonoscopy, and radiotherapy showed statistically significant results with respect to an increase in anxiety and decrease in quality of life measured by the EORTC. However, undergoing radiotherapy at a specified moment increased depression levels, and overall, receiving radiotherapy decreased the quality of life of the patients, as measured by the EuroQol-5d.
After adjustment for sociodemographic factors, comorbidities, and severity of the disease, performing certain quality indicators of proper health care in patients with colorectal cancer was related to less mortality but higher adverse outcomes.
ClinicalTrials.gov Identifier: NCT02488161.
已经确定了一些结直肠癌患者适当医疗保健的质量指标。
我们的目标是评估某些程序或治疗的执行情况（包括作为质量指标）与结直肠癌患者随访中的某些指标的结果之间的关系。
这是一项对接受手术并在 1、2、3 和 5 年进行随访的结直肠癌患者进行的前瞻性队列研究。评估了 CT 扫描、结肠镜检查、化疗和放疗与各种临床结果和 5 年内 PROM 变化的关系。使用多变量广义线性混合模型评估它们对下一次随访时死亡率、并发症、复发和 PROM 变化（HAD、EQ-5D、EORTC-Q30）的影响。
CT 扫描或结肠镜检查与降低死亡风险相关，而特定时间点的化疗与增加风险相关。在复发的情况下，CT 扫描和化疗显示出统计学上增加的风险，而所有的程序和治疗都影响了并发症。关于 PROM 量表，CT 扫描、结肠镜检查和放疗在焦虑方面表现出统计学上显著的结果，而生活质量在 EORTC 方面下降。然而，在特定时间接受放疗会增加抑郁水平，并且总体而言，放疗会降低患者的生活质量，这是通过 EuroQol-5d 测量的。
在调整社会人口统计学因素、合并症和疾病严重程度后，对结直肠癌患者进行某些适当医疗保健的质量指标与降低死亡率但增加不良结局相关。
ClinicalTrials.gov 标识符：NCT02488161。
