Institute of Collective Health, Federal University of Mato Grosso, Av. Fernando Correa da Costa, nº 2367 - Bairro Boa Esperança, Cuiabá, Mato Grosso, 78060-900, Brazil.
State Secretary of Health of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
World J Surg Oncol. 2024 Oct 9;22(1):269. doi: 10.1186/s12957-024-03518-y.
Cervical cancer (CC) is a serious public health concern, being the fourth most common cancer among women and a leading cause of cancer mortality. In Brazil, many women are diagnosed late, and in Mato Grosso, with its geographical diversity, there are specific challenges. This study analyzed hospital survival and its predictors using data from the Hospital Information System (SIH) of the Unified Health System (SUS) in Mato Grosso from 2011 to 2023.
Cox regression and Kaplan-Meier models were applied to determine survival time and identify mortality predictors. The adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was used to measure the association between the factors analyzed.
The hospital mortality rate was 9.88%. The median duration of hospitalization was 33 days (interquartile range [IQR]: 12-36), with a median survival of 43.7%. Patients were followed up for up to 70 days. In the multivariable Cox model, after adjusting for potential confounders, the risk of death during hospitalization was higher in patients aged 40-59 years (AHR = 1.39, p = 0.027) and 60-74 years (AHR = 1.54, p = 0.007), in the absence of surgical procedures (AHR = 4.48, p < 0.001), in patients with medium service complexity (AHR = 2.40, p = 0.037), and in the use of ICU (AHR = 4.97, p < 0.001). On the other hand, patients with hospital expenses above the median (152.971 USD) showed a reduced risk of death (AHR = 0.21, p < 0.001).
This study highlights that hospitalized CC patients have reduced survival, underscoring the need for interventions to improve care, including strategies for early diagnosis and expanded access to adequately resourced health services.
宫颈癌（CC）是一个严重的公共卫生问题，是女性中第四常见的癌症，也是癌症死亡的主要原因。在巴西，许多女性被诊断为晚期，而在地理多样性的马托格罗索州，存在着具体的挑战。本研究使用马托格罗索州统一卫生系统（SUS）医院信息系统（SIH）的数据，从 2011 年至 2023 年分析了医院生存率及其预测因素。
应用 Cox 回归和 Kaplan-Meier 模型确定生存时间并确定死亡率预测因素。使用调整后的危害比（AHR）和 95%置信区间（CI）来衡量分析因素之间的关联。
医院死亡率为 9.88%。住院中位数为 33 天（四分位距 [IQR]：12-36），中位生存时间为 43.7%。患者随访最长可达 70 天。在多变量 Cox 模型中，在校正了潜在混杂因素后，40-59 岁（AHR=1.39，p=0.027）和 60-74 岁（AHR=1.54，p=0.007）的患者住院期间死亡风险较高，无手术（AHR=4.48，p<0.001），中等服务复杂性（AHR=2.40，p=0.037），使用 ICU（AHR=4.97，p<0.001）。另一方面，住院费用高于中位数（152.971 美元）的患者死亡风险降低（AHR=0.21，p<0.001）。
本研究强调，住院的 CC 患者生存率降低，这表明需要采取干预措施来改善护理，包括早期诊断和扩大获得资源充足的卫生服务的策略。
