Brit J Cancer:癌症诊断前精神病学医疗资源利用情况对实体器官恶性肿瘤存活的影响

2019-03-06 xing.T 网络

由此可见,癌症诊断前PU与实体器官恶性肿瘤患者诊断后较差的CSM和ACM独立相关。

在癌症患者中,先前的研究表明精神疾病的患者可能会降低生存率。近日,肿瘤领域权威杂志British Journal of Cancer上发表了一篇研究文章,研究人员旨在评估癌症诊断前精神病学医疗资源利用(PU)对患者生存结局的影响。

研究人员纳入了安大略省的所有居民被诊断为十大恶性肿瘤之一(1997-2014)的患者。主要暴露指标是癌症诊断前5年精神病学医疗资源利用等级(PUG)评分:0:无,1:门诊,2:急诊科,3:住院。多变量、原因特异性风险模型用于评估PUG评分对癌症特异性死亡率(CSM)的影响,以及采用Cox比例风险模型评估其对全因死亡率(ACM)的影响。

该研究纳入了676125名患者:359465名(53.2%)患者为PUG0分,304559名(45.0%)患者为PUG1分,7901名(1.2%)患者为PUG2分,以及4200名(0.6%)患者为PUG3分。PUG评分增加与CSM恶化独立相关,在诊断前PU强度具有效应梯度(相比于PUG0):PUG 1为1.05(95%CI为1.04-1.06),PUG 2为1.36(95%CI为1.30-1.42),PUG 3为1.73(95%CI为1.63-1.84)。增加PUG评分也与较差的ACM相关。

由此可见,癌症诊断前PU与实体器官恶性肿瘤患者诊断后较差的CSM和ACM独立相关。

原始出处:

Zachary Klaassen,et al.The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies.British Journal of Cancer. 2019.https://www.nature.com/articles/s41416-019-0390-0

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