Bottura Bruna, Haddad Raphael Federicci, Alvarenga-Bezerra Vanessa, Campos Vinicius, Perez Luiza, Resende Carolina, Asencio Fernanda de Almeida, Liao Adolfo Wenjaw, Gomes Mariano Tamura Vieira, Zlotnik Eduardo, Moretti-Marques Renato
Ginecologia Oncológica, Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho, São Paulo 04378-500, SP, Brazil.
Programa de Saúde da Mulher, Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil.
J Clin Med. 2024 Feb 18;13(4):1145. doi: 10.3390/jcm13041145.
(1) Background: The pandemic led to significant healthcare disruptions, resulting in postponed surgeries and extended waiting times for non-urgent treatments, including hysteroscopies essential for diagnosing endometrial cancer. This study aims to formulate a risk stratification model to enhance the prioritization of hysteroscopy procedures in Brazil; (2) Methods: A case-control study was conducted at Vila Santa Catarina Hospital in São Paulo, analyzing the medical records of 2103 women who underwent hysteroscopy between March 2019 and March 2022. We used bivariate analysis and multivariate linear regression to identify risk factors associated with endometrial cancer and formulate a nomogram; (3) Results: The findings revealed a 5.5% incidence of pre-invasive and invasive endometrial disease in the study population, with an average waiting time of 120 days for hysteroscopy procedures. The main risk factors identified were hypertension, diabetes, postmenopausal bleeding, and obesity; (4) Conclusions: This research highlights the urgent need for efficient prioritization of hysteroscopy procedures in the wake of the pandemic. The developed nomogram is an innovative tool for identifying patients at higher risk of endometrial cancer, thus facilitating timely diagnosis and treatment and improving overall patient outcomes in a strained healthcare system.
(1) 背景：疫情导致医疗保健出现重大中断，致使手术推迟，非紧急治疗的等待时间延长，包括诊断子宫内膜癌所必需的宫腔镜检查。本研究旨在制定一种风险分层模型，以提高巴西宫腔镜检查程序的优先排序；(2) 方法：在圣保罗的圣卡塔琳娜医院进行了一项病例对照研究，分析了2019年3月至2022年3月期间接受宫腔镜检查的2103名女性的病历。我们使用二元分析和多元线性回归来确定与子宫内膜癌相关的风险因素，并制定了列线图；(3) 结果：研究结果显示，研究人群中浸润前和浸润性子宫内膜疾病的发病率为5.5%，宫腔镜检查程序的平均等待时间为120天。确定的主要风险因素为高血压、糖尿病、绝经后出血和肥胖；(4) 结论：本研究强调了疫情后对宫腔镜检查程序进行有效优先排序的迫切需求。所开发的列线图是一种创新工具，可用于识别子宫内膜癌风险较高的患者，从而在紧张的医疗系统中促进及时诊断和治疗，并改善患者的总体预后。
