时间到直肠癌的最终治疗护理协调

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-04-02 DOI:10.1016/j.amjsurg.2025.116333

Alexis L. Woods , Axenya Kachen , Rebeka A. Dejenie , Sean M. Flynn , Robert J. Kucejko , Erik R. Noren , Ankit Sarin , Miquell Miller

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引用次数: 0

摘要

及时开始直肠癌治疗可改善预后，标准护理是在诊断后60天内接受最终治疗。方法对某三级肿瘤中心2013-2023年收治的直肠癌患者进行回顾性分析。对患者按60天内的治疗时间和患者的社会人口统计学进行统计分析。结果342例直肠癌患者中有182例（53.2%）治疗时间≤60天。统一护理明显快于碎片化护理（57.5天vs 77.4天，p = 0.002）。与治疗时间（60天）相关的因素：性别（p = 0.03）、年龄（p = 0.004）、保险（p = 0.006）、健康场所指数五分位数（p = 0.02）、离医院的距离（p = 0.01）。多变量分析与女性延迟相关（OR为1.74 [95% CI 1.05-2.91],p = 0.03），与距离医院60英里（OR为60 - 100英里）相关(OR为2.49 [95% CI 1.09-5.85],p = 0.03；在100英里或2.87 (95% CI 1.05 - -8.25), p = 0.04)。结论在本研究中，46.8%的直肠癌患者在确诊后60天开始接受最终治疗。统一护理缩短了治疗时间。女性和住在离医院60英里的地方与延误有关。

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Time to definitive treatment in rectal cancer care coordination

Introduction

Timely initiation of rectal cancer treatment improves outcomes, and standard of care is to receive definitive treatment within 60 days of diagnosis.

Methods

A retrospective review of rectal cancer patients (2013–2023) at a tertiary cancer center was performed. Statistical analysis was conducted on patients stratified to time-to-treatment within 60 days and patient sociodemographics.

Results

182/342 (53.2 %) rectal cancer patients had time-to-treatment ≤60 days. Unified care was significantly faster than fragmented care (57.5 vs 77.4 days, p = 0.002). Factors associated with time-to-treatment >60 days: sex (p = 0.03), age (p = 0.004), insurance (p = 0.006), Healthy Places Index quintile (p = 0.02), distance from hospital (p = 0.01). Multivariable analysis associated delays with females (OR 1.74 [95 % CI 1.05–2.91],p = 0.03), and living >60 miles from the hospital (60–100 miles OR 2.49 [95 % CI 1.09–5.85],p = 0.03; >100 miles OR 2.87 [95 % CI 1.05–8.25],p = 0.04).

Conclusion

In this study, 46.8 % of rectal cancer patients initiated definitive treatment >60 days from diagnosis. Unified care improved time-to-treatment. Female sex and living >60 miles from the hospital were associated with delays.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.