Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan.
College of Medicine, National Yang Ming University, Taipei 11221, Taiwan.
Medicina (Kaunas). 2022 Jan 25;58(2):177. doi: 10.3390/medicina58020177.
: The purpose of the present study was to elucidate the in-hospital and long-term outcomes of patients with head and neck cancer (HNC) bleeding and to analyze the risk factors for mortality. : We included patients who presented to the emergency department (ED) with HNC bleeding. Variables of patients who survived and died were compared and associated factors were investigated by logistic regression and Cox's proportional hazard model. : A total of 125 patients were enrolled in the present study. Fifty-nine (52.8%) patients experienced a recurrent bleeding event. The in-hospital mortality rate was 16%. The overall survival at 1, 3 and 5 years was 48%, 41% and 34%, respectively. The median survival time was 9.2 months. Multivariate logistic regression analyses revealed that risk factors for in-hospital mortality were inotropic support (OR = 10.41; Cl 1.81-59.84; = 0.009), hypopharyngeal cancer (OR = 4.32; Cl 1.29-14.46; = 0.018), and M stage (OR = 5.90; Cl 1.07-32.70; = 0.042). Multivariate Cox regression analyses indicate that heart rate >110 (beats/min) (HR = 2.02; Cl 1.16-3.51; = 0.013), inotropic support (HR = 3.25; Cl 1.20-8.82; = 0.021), and hypopharygneal cancer (HR = 2.22; Cl 1.21-4.06; = 0.010) were all significant independent predictors of poorer overall survival. : HNC bleeding commonly represents the advanced disease stage. Recognition of associated factors aids in the risk stratification of patients with HNC bleeding.
本研究旨在阐明头颈部癌症(HNC)出血患者的住院和长期预后,并分析死亡的相关风险因素。
纳入因 HNC 出血而就诊于急诊的患者。对存活与死亡患者的变量进行比较,并通过逻辑回归和 Cox 比例风险模型分析相关因素。
本研究共纳入 125 例患者,其中 59 例(52.8%)患者出现再次出血。住院死亡率为 16%。1、3、5 年总生存率分别为 48%、41%和 34%,中位生存时间为 9.2 个月。多变量逻辑回归分析显示,住院死亡的相关风险因素包括正性肌力支持(OR=10.41;Cl1.81-59.84;=0.009)、下咽癌(OR=4.32;Cl1.29-14.46;=0.018)和 M 分期(OR=5.90;Cl1.07-32.70;=0.042)。多变量 Cox 回归分析表明,心率>110 次/分(HR=2.02;Cl1.16-3.51;=0.013)、正性肌力支持(HR=3.25;Cl1.20-8.82;=0.021)和下咽癌(HR=2.22;Cl1.21-4.06;=0.010)是影响总生存率的独立危险因素。
HNC 出血通常代表疾病的晚期阶段。识别相关因素有助于对 HNC 出血患者进行风险分层。