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法国肺癌患者早期死亡的风险因素:一项全国性分析。

Risk factors for early mortality of lung cancer patients in France: A nationwide analysis.

机构信息

Département de Pneumologie, CHI de Créteil, Créteil, France.

Centre de Recherche Clinique, CHI de Créteil, Créteil, France.

出版信息

Cancer Med. 2022 Dec;11(24):5025-5034. doi: 10.1002/cam4.4821. Epub 2022 May 14.

Abstract

BACKGROUND

Despite therapeutic advances, lung cancer remains the first cause of death from cancer. The main objective of this study was to identify risk factors associated with death within 3-months of the first hospitalization for lung cancer in France.

METHODS

This analysis included patients with a first hospitalization for lung cancer (between January 1, 2016 and December 31, 2018) according to diagnosis-related groups entered into the French national medical-administrative database. Clinical and socioeconomic parameters and characteristics of that first hospitalization were analyzed. A model predictive of early mortality was developed based on those variables.

RESULTS

The 144,087 included patients were 67% men; median age of 68 [interquartile range 60-76] years; 47% had metastatic disease at diagnosis; and 34% and 23%, respectively, had received systemic treatment or undergone curative surgery. The 3-month mortality was 19%, and significantly higher for those ≥70 versus <70 years old (OR 1.33, 1.22-1.45), men versus. women (OR 1.50, 1.44-1.55), those with metastatic disease at diagnosis (OR, 3.30, 3.18-3.43), first hospitalization via the emergency room (OR 1.65 1.59-1.71) and first hospitalization lasting >30 days (OR, 1.58 1.49-1.68). In contrast, no socioeconomic characteristic was associated with early mortality.

CONCLUSION

Almost 1 in 5 patients diagnosed with lung cancer in France died within 3 months post-diagnosis. Improving survival requires diagnosis at an earlier stage and better organization of diagnosis and specific care pathways.

摘要

背景

尽管治疗取得了进展,但肺癌仍是癌症死亡的首要原因。本研究的主要目的是确定与法国首次因肺癌住院后 3 个月内死亡相关的风险因素。

方法

本分析纳入了 2016 年 1 月 1 日至 2018 年 12 月 31 日期间根据诊断相关组进入法国国家医疗管理数据库的首次因肺癌住院的患者。分析了临床和社会经济参数以及首次住院的特征。根据这些变量开发了一个预测早期死亡率的模型。

结果

纳入的 144087 名患者中,67%为男性;中位年龄为 68[60-76]岁;47%在诊断时患有转移性疾病;分别有 34%和 23%接受了系统治疗或进行了根治性手术。3 个月死亡率为 19%,年龄≥70 岁与<70 岁相比显著更高(OR 1.33,1.22-1.45),男性与女性相比(OR 1.50,1.44-1.55),诊断时患有转移性疾病(OR 3.30,3.18-3.43),通过急诊室入院(OR 1.65,1.59-1.71)和首次住院时间>30 天(OR,1.58,1.49-1.68)。相比之下,没有社会经济特征与早期死亡率相关。

结论

在法国诊断出的肺癌患者中,近 1/5 在诊断后 3 个月内死亡。提高生存率需要更早地诊断,以及更好地组织诊断和特定的护理途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/095f/9761075/bfd96c45d234/CAM4-11-5025-g001.jpg

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