Zhang Yao, Zeng Shicong, Wang Zongwen, Zhu Qiankun, Li Jingtao, Ren Xiaohang, Ma Shuoheng, Tan Gang, Zhai Bo
Department of General Surgery, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, China.
Department of Intervention Radiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, China.
BMC Public Health. 2025 Jan 8;25(1):97. doi: 10.1186/s12889-025-21279-5.
The objective of this research is to statistically assess the risk of cardiovascular mortality (CVM) between patients with small bowel adenocarcinoma (SBA) and the general population. Additionally, it aims to identify CVM-associated risk factors among individuals with SBA.
Data obtained between 2000 and 2017 on SBA patients from the Surveillance, Epidemiology, and End Results (SEER) database were examined. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) were obtained to compare CVM between patients and the general US population. To evaluate the cumulative mortality (CM) rate for all causes of death (COD), cumulative hazard curves were constructed. Two multivariate competing risk models were established to determine the independent predictors for CVM.
In the cohort of 5,175 SBA patients observed for 15,068.24 person-years, a total of 205 deaths were attributed to cardiovascular disease (CVD). The overall SMR of CVM was 1.41 (95% confidence interval (CI): 1.23-1.62, P < 0.05), whereas it reached 2.99 during the early stage of latency. Additionally, independent risk factors for CVM included age, marital status, calendar year of diagnosis, disease differentiation degree, SEER stage, and chemotherapy status.
SBA patients exhibited a substantially elevated risk of developing CVM compared to the general US population. During the follow-up period, the CM rate for CVM continued to rise steadily. Timely identification of high-risk groups and effective interventions to safeguard cardiovascular health significantly improve patient prognosis.
本研究的目的是通过统计学方法评估小肠腺癌（SBA）患者与普通人群之间心血管疾病死亡率（CVM）的风险。此外，旨在确定SBA患者中与CVM相关的风险因素。
对2000年至2017年期间从监测、流行病学和最终结果（SEER）数据库中获取的SBA患者数据进行了检查。获得标准化死亡率（SMR）和绝对超额风险（AER），以比较患者与美国普通人群之间的CVM。为评估所有死因（COD）的累积死亡率（CM），构建了累积风险曲线。建立了两个多变量竞争风险模型，以确定CVM的独立预测因素。
在观察了15068.24人年的5175例SBA患者队列中，共有205例死亡归因于心血管疾病（CVD）。CVM的总体SMR为1.41（95%置信区间（CI）：1.23 - 1.62，P < 0.05），而在潜伏期早期达到2.99。此外，CVM的独立风险因素包括年龄、婚姻状况、诊断年份、疾病分化程度、SEER分期和化疗状态。
与美国普通人群相比，SBA患者发生CVM的风险显著升高。在随访期间，CVM的CM率持续稳步上升。及时识别高危人群并采取有效的心血管健康干预措施可显著改善患者预后。
