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孤独感预测癌症患者死亡率:一项队列研究。

Loneliness as a predictor of mortality in cancer patients, a cohort study.

机构信息

Grupo del Área de Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología ESE, Bogotá, D.C., Colombia; Grupo de Epidemiología y Evaluación en Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.

Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.

出版信息

Biomedica. 2024 May 31;44(Sp. 1):119-138. doi: 10.7705/biomedica.7150.

Abstract

Introduction. Some studies have indicated that loneliness may be associated with an increased risk of mortality in cancer patients, as it can weaken treatment response and the immune system, and promote harmful behaviors, worsening the prognosis and increasing the likelihood of death. Addressing loneliness in public health is essential to provide social support and improve outcomes in cancer patients. Objective. To obtain an estimator of the unwanted loneliness-mortality association. Materials and methods. We followed a prospective cohort of 400 patients for two years (exposure=loneliness levels; outcome=mortality; sociodemographic and clinical control variables were included). A parametric survival model (log normal) was used. Results. The cohort had a median survival of 20.2 months and a mortality rate of 3.2 deaths/100 patient-months (95% CI: 2.8 to 3.7). The survival model found the following time ratios (TR): moderate level/low level: TR=0.55; 95% CI: 0.39 to 0.77; moderately high level/low level: TR=0.62; 95% CI: 0.41 to 0.93; high level/low level: TR=1.17; 95% CI: 0.31 to 4.42. Conclusion. Compared to patients with low levels of loneliness, patients with moderate or moderately high levels reach death more quickly (statistically significant TRs, adjusted for the effect of other variables in the model); this highlights the need for interventions to mitigate loneliness and promote social support in patients having cancer.

摘要

简介。一些研究表明,孤独感可能与癌症患者的死亡率增加有关,因为它会削弱治疗反应和免疫系统,并促进有害行为,从而恶化预后并增加死亡的可能性。在公共卫生领域解决孤独感对于为癌症患者提供社会支持和改善预后至关重要。目的。获得孤独感与死亡率之间不良关联的估计值。材料和方法。我们对 400 名患者进行了为期两年的前瞻性队列研究(暴露=孤独水平;结局=死亡率;包括社会人口学和临床控制变量)。使用参数生存模型(对数正态分布)。结果。该队列的中位生存时间为 20.2 个月,死亡率为 3.2 例死亡/100 患者-月(95%CI:2.8 至 3.7)。生存模型发现以下时间比(TR):中度水平/低度水平:TR=0.55;95%CI:0.39 至 0.77;中高度水平/低度水平:TR=0.62;95%CI:0.41 至 0.93;高度水平/低度水平:TR=1.17;95%CI:0.31 至 4.42。结论。与孤独感水平较低的患者相比,孤独感处于中度或中高度水平的患者死亡速度更快(TR 具有统计学意义,调整了模型中其他变量的影响);这强调了需要采取干预措施来减轻癌症患者的孤独感并促进社会支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8201/11418832/aba44135ad1f/2590-7379-bio-44-s1-7150-gf1.jpg

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