Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, 48960, Spain.
Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain.
Eur J Cancer Care (Engl). 2022 Mar;31(2):e13561. doi: 10.1111/ecc.13561. Epub 2022 Feb 16.
The objective of this work is to evaluate the association of comorbidities with various outcomes in patients diagnosed with colon or rectal cancer.
We conducted a prospective cohort study of patients diagnosed with colon or rectal cancer who underwent surgery. Data were gathered on sociodemographic, clinical characteristics, disease course, and the EuroQol EQ-5D and EORTC QLQ-C30 scores, up to 5 years after surgery. The main outcomes of the study were mortality, complications, readmissions, reoperations, and changes in PROMs up to 5 years. Multivariable multilevel logistic regression models were used in the analyses.
Mortality at some point during the 5-year follow-up was related to cardiocerebrovascular, hemiplegia and/or stroke, chronic obstructive pulmonary disease (COPD), diabetes, cancer, and dementia. Similarly, complications were related to cardiovascular disease, COPD, diabetes, hepatitis, hepatic or renal pathologies, and dementia; readmissions to cardiovascular disease, COPD, and hepatic pathologies; and reoperations to cerebrovascular and diabetes. Finally, changes in EQ-5D scores at some point during follow-up were related to cardiocerebrovascular disease, COPD, diabetes, pre-existing cancer, hepatic and gastrointestinal pathologies, and changes in EORTC QLQ-C30 scores to cardiovascular disease, COPD, diabetes, and hepatic and gastrointestinal pathologies.
Optimising the management of the comorbidities most strongly related to adverse outcomes may help to reduce those events in these patients.
本研究旨在评估合并症与诊断为结肠癌或直肠癌患者的各种结局之间的关联。
我们对接受手术治疗的结肠癌或直肠癌患者进行了前瞻性队列研究。收集了患者的社会人口学、临床特征、疾病过程以及 EuroQol EQ-5D 和 EORTC QLQ-C30 评分数据，随访时间长达 5 年。本研究的主要结局包括 5 年内的死亡率、并发症、再入院、再次手术以及患者报告的结局变化。采用多变量多级逻辑回归模型进行分析。
在 5 年随访期间的某个时间点，死亡率与心血管-脑血管疾病、偏瘫和/或中风、慢性阻塞性肺疾病（COPD）、糖尿病、癌症和痴呆有关。同样，并发症与心血管疾病、COPD、糖尿病、肝炎、肝脏或肾脏疾病以及痴呆有关；再入院与心血管疾病、COPD 和肝脏疾病有关；再次手术与脑血管疾病和糖尿病有关。最后，在随访期间的某个时间点，EQ-5D 评分的变化与心血管-脑血管疾病、COPD、糖尿病、预先存在的癌症、肝脏和胃肠道疾病有关，EORTC QLQ-C30 评分的变化与心血管疾病、COPD、糖尿病以及肝脏和胃肠道疾病有关。
优化与不良结局密切相关的合并症的管理可能有助于减少这些患者的不良事件。
