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在随机对照体力活动试验(PhysSURG-B)中,乳腺癌手术后 12 个月的病假和病假预测因素。

Sick leave and predictive factors for sick leave at 12 months after breast cancer surgery in the randomized controlled physical activity trial (PhysSURG-B).

机构信息

Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden.

Jostat & Mr Sample AB, Gothenburg, Sweden.

出版信息

Surgeon. 2023 Oct;21(5):e229-e237. doi: 10.1016/j.surge.2022.12.001. Epub 2023 Jan 2.

Abstract

OBJECTIVE

To evaluate sick leave 12 months after breast cancer surgery, to analyze the effect of adjuvant chemotherapy and to identify predictive factors for sick leave, based on a randomized controlled trial of a non-supervised physical activity intervention (PhysSURG-B).

METHODS

Sick leave days (for patients age 18-67) were collected from the Swedish Social Insurance Agency, and compared between the intervention and control arm in the trial. A random forest model was used to analyze predictive factors for sick leave, including baseline patient and tumor characteristics as well as patient-reported outcomes measuring quality of life, personality traits, pain, anxiety and depression.

RESULTS

A total of 203 patients were analyzed, and when comparing intervention to control, there was no differences in sick leave days (117 vs 55 days, odds ratio 1.21; 95% CI 0.75-1.96). Adjuvant chemotherapy significantly increased days of sick leave (323 vs 42 days, odds ratio 17.3; 95% CI 9.15-34.2). Factors predicting prolonged sick leave were adjuvant chemotherapy, young age, previous mental health problems and low quality of life (measured as FACT-B score) at baseline.

CONCLUSION

A non-supervised physical activity intervention had no effect on sick leave 12 months after surgery. Significantly longer sick leave was seen in patients treated by adjuvant chemotherapy. Factors predicting prolonged sick leave can be recognized at baseline and utilized when designing future interventions.

摘要

目的

评估乳腺癌手术后 12 个月的病假情况,分析辅助化疗的效果,并基于非监督体力活动干预(PhysSURG-B)的随机对照试验,确定病假的预测因素。

方法

从瑞典社会保险局收集病假天数(适用于 18-67 岁的患者),并在试验中比较干预组和对照组的病假天数。使用随机森林模型分析病假的预测因素,包括基线患者和肿瘤特征以及患者报告的生活质量、人格特质、疼痛、焦虑和抑郁测量结果。

结果

共分析了 203 名患者,干预组与对照组相比,病假天数无差异(117 天 vs 55 天,优势比 1.21;95%置信区间 0.75-1.96)。辅助化疗显著增加了病假天数(323 天 vs 42 天,优势比 17.3;95%置信区间 9.15-34.2)。预测病假延长的因素包括辅助化疗、年龄较小、先前存在心理健康问题和基线时生活质量较低(以 FACT-B 评分衡量)。

结论

非监督体力活动干预对手术后 12 个月的病假没有影响。接受辅助化疗的患者病假时间明显延长。可以在基线时识别出预测病假延长的因素,并在设计未来干预措施时加以利用。

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