Svanes C, Lie R T, Lie S A, Kvåle G, Svanes K, Søreide O
Department of Surgery, Haukeland Hospital, Oslo, Norway.
J Clin Epidemiol. 1996 Dec;49(12):1363-71. doi: 10.1016/s0895-4356(96)00278-8.
The survival of 1098 patients with ulcer perforation in Norway during the period 1952-1990 was compared with expected survival. Cox regression models incorporating population mortality rates, were used to analyse effects of sex, age, year of birth, and year at risk on excess mortality. Survival was lower in patients than in the general population through a follow-up period of 38 years. Relative survival was lower in women as compared to men, due to more delayed treatment. Long-term survival was lower after praepyloric perforations than after the other perforation types. Relative survival was higher in patients treated 1952-1970 than in those treated more recently. However, adjustment for year of birth revealed a decline in short-term mortality with calendar time, which is in accordance with improved management during the study period. Relative mortality, particularly long-term mortality, was higher in younger birth cohorts, suggesting a shift towards more serious etiologies.
对1952年至1990年期间挪威1098例溃疡穿孔患者的生存情况与预期生存情况进行了比较。采用纳入人群死亡率的Cox回归模型分析性别、年龄、出生年份和风险年份对超额死亡率的影响。在38年的随访期内，患者的生存率低于一般人群。由于治疗延迟较多，女性的相对生存率低于男性。幽门前穿孔后的长期生存率低于其他类型的穿孔。1952年至1970年接受治疗的患者的相对生存率高于近期接受治疗的患者。然而，对出生年份进行调整后发现，短期死亡率随日历时间呈下降趋势，这与研究期间管理的改善相一致。相对死亡率，尤其是长期死亡率，在较年轻的出生队列中较高，这表明病因有向更严重方向转变的趋势。
