Huh Youn, Kim Hae-Rim, Kim Hwa Jung, Son Ki Young
Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi-do, Republic of Korea.
College of Natural Science, School of Statistics, University of Seoul, Seoul, Republic of Korea.
Front Med (Lausanne). 2024 Oct 14;11:1400049. doi: 10.3389/fmed.2024.1400049. eCollection 2024.
To develop an accurate mortality risk predictive model among patients with lung cancer.
The development cohort included 96,255 patients with lung cancer aged ≥19 years, who underwent a Korean National Health Insurance Service health check-up from 2005 to 2015. The validation cohort consisted of 18,432 patients (≥19 years) with lung cancer from another region. The outcome was all-cause mortality between January 1, 2005, and December 31, 2020.
Approximately 60.5% of the development cohort died within a median follow-up period of 2.32 (0.72-5.00) years. Risk score was highest in participants aged ≥65 years, followed by those who underwent treatment, had a history of emergency room visits, and were current smokers. Participants treated by surgery had the lowest risk score, followed by combined surgery and chemotherapy, combined surgery and radiation therapy, women, and regular exercisers. The C statistic in the development and validation cohorts was 0.78 (95% confidence interval, 0.77-0.78) and 0.81 (95% confidence interval, 0.78-0.84), respectively.
Advanced age, lung cancer stage, and treatment type were strong risk factors of mortality in lung cancer patients, while being a woman and exercise were preventive factors. These will aid in the prediction of mortality and management of lung cancer patients.
建立一个准确的肺癌患者死亡风险预测模型。
开发队列包括96255例年龄≥19岁的肺癌患者,他们在2005年至2015年期间接受了韩国国民健康保险服务健康检查。验证队列由来自另一个地区的18432例(≥19岁)肺癌患者组成。结局为2005年1月1日至2020年12月31日期间的全因死亡率。
在中位随访期2.32(0.72 - 5.00)年期间,开发队列中约60.5%的患者死亡。风险评分在年龄≥65岁的参与者中最高,其次是接受过治疗、有急诊就诊史和当前吸烟者。接受手术治疗的参与者风险评分最低,其次是手术联合化疗、手术联合放疗、女性和经常锻炼者。开发队列和验证队列中的C统计量分别为0.78(95%置信区间,0.77 - 0.78)和0.81(95%置信区间,0.78 - 0.84)。
高龄、肺癌分期和治疗类型是肺癌患者死亡的强风险因素,而女性和运动是预防因素。这些将有助于预测肺癌患者的死亡率并进行管理。