Frequency and Natural History of Emergency General Surgery Conditions in Cancer Patients: A SEER-Medicare Population Analysis.

IF 7.5 1区 医学 Q1 SURGERY
Joshua S Jolissaint, Stephanie M Lobaugh, Debra A Goldman, Sarah M McIntyre, Elvira L Vos, Katherine S Panageas, Alice C Wei
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引用次数: 0

Abstract

Objective: To determine if cancer patients experience variability in incidence or management of emergency general surgery (EGS) conditions compared to non-cancer patients.

Background: The true frequency, and natural history of EGS conditions among cancer patients has not been characterized.

Methods: We utilized SEER-Medicare data from January 2006-December 2015 to compare patients with breast, prostate, and lung cancer to a non-cancer cohort. Patients were followed from date of cancer diagnosis, or an index date for non-cancer patients, to the development of an EGS condition, death or last follow up. We assessed the cumulative incidence of EGS conditions over time, and fit multivariable Cox proportional hazards models to evaluate the impact of time-dependent surgical intervention on mortality.

Results: We identified 322,756 patients with breast (N=82,147), lung (N=128,618), and prostate cancer (N=111,991) and 210,429 non-cancer patients.. Cancer patients had a higher incidence of an EGS condition within the first year after diagnosis (4.8% vs. 3.2%), with lung (6.8%) and breast cancer (4.0%) showing consistent rends. Cancer patients were less likely to undergo surgery for (13% vs. 14%, P=0.005), though this varied by cancer type and EGS conditions. Patients with breast (HR 1.27, 95%CI 1.17-1.39) and lung cancer (HR 3.27, 95%CI 3.07-3.48) were more likely to die within 30-days of an EGS diagnosis.

Conclusions: Cancer patients experience a higher incidence of EGS conditions within the first year following diagnosis, but are less likely to undergo surgery. Future research is needed to explore the interplay between EGS conditions, their management, and receipt of intended oncologic therapy, and resulting outcomes.

癌症患者接受普通外科急诊的频率和自然病史:SEER-Medicare 人口分析。
目的: 确定与非癌症患者相比,癌症患者的急诊普外科(EGS)病症发生率或管理是否存在差异:确定与非癌症患者相比,癌症患者在急诊普外科(EGS)病症的发生率或管理方面是否存在差异:癌症患者中 EGS 病症的真实频率和自然病史尚未确定:我们利用 SEER-Medicare 2006 年 1 月至 2015 年 12 月的数据,将乳腺癌、前列腺癌和肺癌患者与非癌症患者进行了比较。从癌症确诊日期或非癌症患者的指数日期开始,对患者进行随访,直至出现 EGS 病症、死亡或最后一次随访。我们评估了 EGS 病症随时间变化的累积发病率,并建立了多变量 Cox 比例危险模型,以评估随时间变化的手术干预对死亡率的影响:我们确定了 322,756 名乳腺癌(82,147 人)、肺癌(128,618 人)和前列腺癌(111,991 人)患者以及 210,429 名非癌症患者。癌症患者在确诊后第一年内的 EGS 发病率较高(4.8% 对 3.2%),其中肺癌(6.8%)和乳腺癌(4.0%)的发病率呈持续上升趋势。癌症患者接受手术的几率较低(13% vs. 14%,P=0.005),但这因癌症类型和 EGS 状况而异。乳腺癌(HR 1.27,95%CI 1.17-1.39)和肺癌(HR 3.27,95%CI 3.07-3.48)患者更有可能在确诊 EGS 后 30 天内死亡:结论:癌症患者在确诊后第一年内发生 EGS 的几率较高,但接受手术的几率较低。未来的研究需要探索 EGS 病症、其管理和接受预期肿瘤治疗之间的相互作用以及由此产生的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of surgery
Annals of surgery 医学-外科
CiteScore
14.40
自引率
4.40%
发文量
687
审稿时长
4 months
期刊介绍: The Annals of Surgery is a renowned surgery journal, recognized globally for its extensive scholarly references. It serves as a valuable resource for the international medical community by disseminating knowledge regarding important developments in surgical science and practice. Surgeons regularly turn to the Annals of Surgery to stay updated on innovative practices and techniques. The journal also offers special editorial features such as "Advances in Surgical Technique," offering timely coverage of ongoing clinical issues. Additionally, the journal publishes monthly review articles that address the latest concerns in surgical practice.
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