急性白血病：与计划外诊断途径相关的患者因素及其对生存的影响——丹麦一项全国性的基于登记的队列研究

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-07-10 DOI:10.1016/j.canep.2025.102874

Line Flytkjær Virgilsen , Peter Vedsted , Henry Jensen , Henrik Frederiksen , Tarec Christoffer El-Galaly , Anne Stidsholt Roug , Linda Aagaard Rasmussen

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引用次数: 0

摘要

背景：急性白血病（AL）是一种侵袭性血液学癌症。本研究探讨了非计划诊断途径中的患者因素及其与患者预后和死亡率的关系。方法：这项基于全国登记的研究纳入了2014-2018年丹麦所有诊断为AL的患者。诊断途径分为选择性途径和非计划途径（诊断前30天内急性入院和无计划入院）。结果我们纳入了1495例AL患者，诊断途径没有因社会人口学特征而异。世卫组织绩效评分为2-4的患者在计划外途径中被诊断的概率为64% %(95 %可信区间（CI） 59-69 %)，而世卫组织绩效评分为0-1的患者为47 %（95 % CI 44-50 %）。高合并症水平与计划外途径的可能性较高相关。非计划路径患者的一年生存率低于选择路径患者(调整后全因死亡率风险比：1.44（95 % CI 1.29-1.62）。这种生存差异在延迟3个月进入的里程碑分析中消失。结论成绩评分低、合并症发生率高的患者更易出现计划外诊断途径。非计划途径与诊断后3个月内较低的生存率和死亡率相关。

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Acute leukaemia: Patient factors associated with unplanned diagnostic pathways and the impact on survival – A nationwide register-based cohort study in Denmark

Background

Acute leukaemia (AL) is an aggressive haematological cancer. This study investigated patient factors in unplanned diagnostic pathways and the association with the prognosis and mortality of patients.

Methods

This nationwide register-based study included all patients diagnosed with AL in Denmark in 2014–2018. Diagnostic pathways were divided into elective pathways and unplanned pathways (acute admission within up to 30 days before diagnosis and no planned admissions).

Results

We included 1495 patients with AL. Diagnostic pathway did not differ by sociodemographic characteristics. Patients with a WHO performance score of 2–4 had a 64 % probability of being diagnosed in an unplanned pathway (95 % confidence interval (CI) 59–69 %) versus 47 % (95 % CI 44–50 %) in patients with a WHO performance score of 0–1. High comorbidity level was associated with higher probability of unplanned pathways. Patients in unplanned pathways had lower one-year survival than patients in elective pathways (adjusted all-cause mortality hazard ratio: 1.44 (95 % CI 1.29–1.62). This survival difference disappeared in landmark analyses with three-month delayed entry.

Conclusions

Patients with impaired performance score and high comorbidity level more often experienced an unplanned diagnostic pathway. Unplanned pathway was associated with lower survival and death within 3 months after the diagnosis.

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.