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晚期前列腺癌男性的合并症负担和与健康相关的生活质量。

Comorbidity burden and health-related quality of life in men with advanced prostate cancer.

机构信息

Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Flipse Building, 5thFloor, Coral Gables, Miami, FL, 33146, USA.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

Support Care Cancer. 2023 Jul 28;31(8):496. doi: 10.1007/s00520-023-07962-6.

DOI:10.1007/s00520-023-07962-6
PMID:37501020
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10644679/
Abstract

PURPOSE

Identifying clinically relevant comorbidities and their effect on health-related quality of life (HRQoL) outcomes among men with advanced prostate cancer (APC) can inform patient care and improve outcomes; however, this is poorly understood. The aim of this observational study was to examine the prevalence of comorbidities, and the relationship of comorbidity burden to HRQoL and other patient-reported outcomes (PROs) among men with APC.

METHODS

Participants were 192 men (average age 68.8) with APC (stage III or IV) who completed a psychosocial battery including measures of sociodemographic factors, HRQoL and other PROs, and the Charlson Comorbidity Index (CCI). Hierarchical multiple regression analysis was used to examine the relationships between CCI, HRQOL, and PROs.

RESULTS

The vast majority (82%) of participants had at least one comorbidity, with the most common being: hypertension (59%), connective tissue disease or arthritis (31%), diabetes (24%), and problems with kidneys, vision, or another organ (24%). After controlling for covariates, regressions showed that a higher CCI score was significantly associated with worse HRQoL (p < 0.001), lower levels of positive affect (p < 0.05), and higher levels of depression (p < 0.05), fatigue (p < 0.001), pain (p < 0.01), stress (p < 0.01), and cancer-specific distress (p < 0.05).

CONCLUSIONS

Comorbidities were common among men with APC, and a greater CCI score was associated with detriments in several domains of HRQoL and other PROs. Our findings show the need to address comorbidities in the presence of a cancer diagnosis and subsequent treatment. TRIAL REGISTRATION CLINICALTRIALS.

GOV IDENTIFIER

NCT03149185.

摘要

目的

在患有晚期前列腺癌(APC)的男性中,确定与临床相关的合并症及其对健康相关生活质量(HRQoL)结果的影响,可以为患者提供护理并改善预后;然而,目前对此知之甚少。本观察性研究的目的是检查合并症的患病率,以及合并症负担与 APC 男性的 HRQoL 和其他患者报告的结局(PRO)之间的关系。

方法

192 名平均年龄为 68.8 岁的 APC(III 期或 IV 期)男性患者完成了心理社会测试,包括社会人口统计学因素、HRQoL 和其他 PRO 以及 Charlson 合并症指数(CCI)的测量。采用分层多重回归分析来检验 CCI、HRQOL 和 PRO 之间的关系。

结果

绝大多数(82%)患者存在至少一种合并症,最常见的是:高血压(59%)、结缔组织疾病或关节炎(31%)、糖尿病(24%)以及肾脏、视力或其他器官问题(24%)。在控制了协变量后,回归分析显示,CCI 评分越高与 HRQoL 越差显著相关(p<0.001),积极情绪水平越低(p<0.05),抑郁水平越高(p<0.05),疲劳感越重(p<0.001),疼痛程度越重(p<0.01),压力越大(p<0.01),癌症特异性困扰越大(p<0.05)。

结论

APC 男性中合并症很常见,CCI 评分越高,HRQoL 和其他 PRO 多个领域的受损程度越大。我们的研究结果表明,在诊断癌症及随后的治疗中,需要解决合并症的问题。临床试验注册号:NCT03149185。