分析肺癌患者的诊断和治疗等待时间:一项省级登记研究的重要启示。

IF 4.5 2区 医学 Q1 ONCOLOGY
Manuel Luis Blanco-Villar , José Expósito-Hernández , Eulalia Navarro-Moreno , José María López Martín , Adrián Aparicio Mota , Felipe Couñago
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引用次数: 0

摘要

背景:肺癌(LC)仍然是全球癌症相关死亡的主要原因,因此需要及时诊断和治疗以改善患者预后。本研究旨在评估西班牙阿尔梅里亚一家公立医院为肺癌患者提供治疗的及时性,评估指南的遵守情况,并探讨及时性与生存率之间的关系:进行了一项回顾性队列研究,回顾了 2019 年至 2021 年期间确诊的 LC 患者的医疗记录。根据现行指南改编的质量指标有助于评估护理的及时性,重点是诊断和治疗的等待时间。在调整了包括年龄、表现状态、分期、组织学和治疗方式在内的协变量后,采用了Cox回归模型来探讨生存相关性:在纳入的 539 名患者中,大多数患者(79.84%)在 7 天内与专家取得了初步联系,82.25% 的患者在 30 天内得到了诊断。然而,在开始治疗时出现了延误,其中手术治疗的中位等待时间最长(78 天)。生存分析表明,较短和较长的诊断间隔(HR:0.87,95 % CI:0.62-1.24)或治疗间隔(HR:1.14,95 % CI:0.83-1.58)之间无明显差异。多变量分析确定年龄、表现状态、分期、组织学和治疗是预后因素:本研究强调了及时诊断和治疗对改善肺癌预后的重要性。尽管达到了诊断目标,但治疗延误的情况很普遍,尤其是手术治疗。这些发现强调了加强协调和高效护理路径的必要性,以尽量减少延误,最终提高肺癌患者的生存率和生活质量。解决这些问题对于优化未来的肺癌治疗至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analyzing diagnostic and treatment wait times for lung cancer Patients: Key insights from a provincial registry study

Background

Lung cancer (LC) remains the leading cause of cancer-related mortality globally, necessitating timely diagnosis and treatment to improve patient outcomes. This study aimed to evaluate the timeliness of care for LC patients at a public hospital in Almería, Spain, assess adherence to guidelines, and explore associations between timeliness and survival.

Methods

A retrospective cohort study was conducted, reviewing medical records of LC patients diagnosed between 2019 and 2021. Quality indicators, adapted from prevailing guidelines, facilitated the assessment of care timeliness, with a focus on diagnostic and treatment wait times. Cox regression modeling was employed to explore survival associations, adjusting for covariates including age, performance status, stage, histology, and treatment modalities.

Results

Of 539 patients included, most (79.84 %) had initial specialist contact within 7 days, and 82.25 % received diagnosis within 30 days. However, delays were observed in treatment initiation, with surgery experiencing the longest median wait time (78 days). Survival analysis showed no significant difference between shorter and longer diagnostic (HR: 0.87, 95 % CI: 0.62–1.24) or treatment intervals (HR: 1.14, 95 % CI: 0.83–1.58). Multivariate analysis identified age, performance status, stage, histology, and treatment as prognostic factors.

Conclusion

This study highlights the importance of timely diagnosis and treatment in improving lung cancer outcomes. Despite achieving diagnostic targets, treatment delays were common, particularly for surgical interventions. These findings underscore the need for enhanced coordination and efficient care pathways to minimize delays, ultimately improving survival rates and quality of life for lung cancer patients. Addressing these issues is crucial for optimizing lung cancer care delivery in the future.

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来源期刊
Lung Cancer
Lung Cancer 医学-呼吸系统
CiteScore
9.40
自引率
3.80%
发文量
407
审稿时长
25 days
期刊介绍: Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.
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