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日常生活风险对乳腺癌相关淋巴水肿的影响。

The Effects of Daily-Living Risks on Breast Cancer-Related Lymphedema.

机构信息

School of Nursing and Health Studies, University of Missouri -Kansas City, Kansas City, MO, USA.

Division of Computing, Analytics, and Mathematics, School of Science and Engineering, University of Missouri -Kansas City, Kansas City, MO, USA.

出版信息

Ann Surg Oncol. 2024 Nov;31(12):8076-8085. doi: 10.1245/s10434-024-15946-x. Epub 2024 Aug 1.

Abstract

BACKGROUND

Conventional advice to reduce the risk of breast cancer-related lymphedema (BCLE) suggests avoidance of daily-living risks, and limited research has investigated these risks.

OBJECTIVE

This study aimed to examine the occurrence, patterns, and effects of daily-living risks on BCLE.

METHODS

A cross-sectional design was used to collect data from 567 patients at a metropolitan cancer center in the United States. The Lymphedema Risk-Reduction Behavior Checklist was used to assess the occurrence of 11 daily-living risks. Descriptive, regression, and factor analyses were performed.

RESULTS

Significant odds of BCLE were associated with infection (odds ratio [OR] 2.58, 95% confidence interval [CI] 1.95-3.42), cuts/scratches (OR 2.65, 95% CI 1.97-3.56), sunburn (OR 1.89, 95% CI 1.39-3.56), oil splash or steam burns (OR 2.08, 95% CI 1.53-3.83), and insect bites (OR 1.59, 95% CI 1.18-2.13). The daily-living risks were clustered into factors related to skin trauma and carrying objects. Skin trauma risk was significantly associated with BCLE (B = 0.539, z = 3.926, OR 1.714, 95% CI 1.312-2.250; p < 0.001). Having three, four, or five skin trauma risks significantly increased the odds of BCLE to 4.31, 5.14, and 6.94 times, respectively. The risk of carrying objects had no significant or incremental effects on BCLE.

CONCLUSION

Complete avoidance of daily-living risks is challenging given 52.73% of patients incurred more than five daily-living risks. Our study findings underscore the importance of 'what to do' strategies to minimize infection and skin trauma.

摘要

背景

为降低乳腺癌相关淋巴水肿(BCLE)风险,传统建议避免日常生活风险,但有限的研究调查了这些风险。

目的

本研究旨在检查日常生活风险的发生、模式及其对 BCLE 的影响。

方法

采用横断面设计,在美国一家大都市癌症中心收集了 567 名患者的数据。使用淋巴水肿风险降低行为检查表评估 11 种日常生活风险的发生情况。进行描述性、回归和因子分析。

结果

BCLE 的显著优势比与感染(比值比 [OR] 2.58,95%置信区间 [CI] 1.95-3.42)、割伤/抓伤(OR 2.65,95% CI 1.97-3.56)、晒伤(OR 1.89,95% CI 1.39-3.56)、油溅或蒸汽烧伤(OR 2.08,95% CI 1.53-3.83)和昆虫叮咬(OR 1.59,95% CI 1.18-2.13)相关。日常生活风险聚类为与皮肤创伤和携带物品相关的因素。皮肤创伤风险与 BCLE 显著相关(B=0.539,z=3.926,OR 1.714,95% CI 1.312-2.250;p<0.001)。发生三种、四种或五种皮肤创伤风险时,BCLE 的优势比分别显著增加至 4.31、5.14 和 6.94 倍。携带物品的风险对 BCLE 没有显著或增量影响。

结论

鉴于 52.73%的患者发生了超过五种日常生活风险,完全避免日常生活风险具有挑战性。本研究结果强调了实施“做什么”策略以最大程度降低感染和皮肤创伤风险的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa64/11466982/a65acd487aa3/10434_2024_15946_Fig1_HTML.jpg

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