Risk assessment and predictive modeling of suicide in multiple myeloma patients.

IF 3.1 2区 医学 Q2 ONCOLOGY Journal of Cancer Survivorship Pub Date : 2024-12-17 DOI:10.1007/s11764-024-01732-x
Jiaxin Shen, Shaoze Lin, Hongfang Tao, Leonardo A Sechi, Claudio Fozza, Xiaofen Wen
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Abstract

Purpose: Despite advancements in treatment that have extended survival, multiple myeloma (MM) remains a distressing diagnosis with significant health impacts, including an elevated risk of suicide. This study aims to investigate suicide risk among MM patients and develop a predictive model to identify high-risk individuals.

Methods: We analyzed 83,333 MM cases from the latest Surveillance, Epidemiology, and End Results (SEER) database (2001-2020) to identify suicide risk predictors and develop prediction nomograms. The cohort was randomly allocated into training and validation groups. Validation included assessing the consistency index (C-index), receiver operating characteristic (ROC) curve, and calibration curve.

Results: Among the cohort, 89 MM patients died by suicide, reflecting a significantly higher rate compared to the general US population (SMR = 2.186). Key risk factors included household income ≤ $50,000 (SMR = 3.82), male sex (SMR = 3.68), and age ≥ 80 years at diagnosis (SMR = 3.05). Additional predictors were unmarried status, Black race, and diagnosis post-2007. The nomogram incorporating these factors demonstrated strong predictive accuracy in both training and validation groups.

Conclusion: This study identified critical suicide risk factors in MM patients and developed a predictive nomogram that aids physicians in the early identification of at-risk individuals, facilitating more effective preventive measures.

Implications for cancer survivors: Utilizing the factors and predictive model for suicide risk among MM survivors allows for earlier identification and intervention, significantly enhancing their quality of life and psychological relief in the context of improved MM survival rates.

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多发性骨髓瘤患者自杀风险评估及预测模型。
目的:尽管治疗的进步延长了患者的生存期,但多发性骨髓瘤(MM)仍然是一种令人痛苦的诊断,具有显著的健康影响,包括自杀风险升高。本研究旨在探讨多发性骨髓瘤患者的自杀风险,并建立预测模型以识别高危人群。方法:我们分析了来自最新监测、流行病学和最终结果(SEER)数据库(2001-2020)的83333例MM病例,以确定自杀风险预测因素并制定预测图。该队列随机分为训练组和验证组。验证包括评估一致性指数(C-index)、受试者工作特征曲线(ROC)和校准曲线。结果:在队列中,89名MM患者死于自杀,与美国普通人群(SMR = 2.186)相比,自杀率明显更高。主要危险因素包括家庭收入≤5万美元(SMR = 3.82)、男性(SMR = 3.68)和诊断时年龄≥80岁(SMR = 3.05)。其他预测因素包括未婚状态、黑人种族和2007年后的诊断。在训练组和验证组中,包含这些因素的nomogram显示了很强的预测准确性。结论:本研究确定了MM患者的关键自杀风险因素,并开发了一种预测nomogram,帮助医生早期识别高危个体,促进更有效的预防措施。对癌症幸存者的启示:利用恶性肿瘤幸存者自杀风险的因素和预测模型,可以更早地识别和干预,在提高恶性肿瘤生存率的背景下,显著提高他们的生活质量和心理缓解。
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
CiteScore
7.00
自引率
10.80%
发文量
149
审稿时长
>12 weeks
期刊介绍: Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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