住院患者死于宫颈癌的时间及其预测因素:巴西马托格罗索州的一项生存方法研究。

IF 2.5 3区 医学 Q3 ONCOLOGY World Journal of Surgical Oncology Pub Date : 2024-10-09 DOI:10.1186/s12957-024-03518-y
Sancho Pedro Xavier, Kátia Moreira da Silva, Noemi Dreyer Galvão, Marco Aurélio Bertúlio das Neves, Adila de Queiroz Neves Almeida, Ageo Mario Cândido da Silva
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引用次数: 0

摘要

背景:宫颈癌(CC)是一个严重的公共卫生问题,是女性第四大常见癌症,也是癌症死亡的主要原因。在巴西,许多妇女确诊较晚,而马托格罗索州因其地理位置的多样性,面临着特殊的挑战。本研究利用马托格罗索州统一卫生系统(SUS)医院信息系统(SIH)2011年至2023年的数据分析了住院生存率及其预测因素:采用 Cox 回归和 Kaplan-Meier 模型确定存活时间并识别死亡率预测因素。采用调整后危险比(AHR)和 95% 置信区间(CI)来衡量分析因素之间的关联:住院死亡率为 9.88%。中位住院时间为 33 天(四分位间距 [IQR]:12-36),中位生存率为 43.7%。对患者进行了长达 70 天的随访。在多变量 Cox 模型中,在调整了潜在的混杂因素后,年龄在 40-59 岁(AHR = 1.39,p = 0.027)和 60-74 岁(AHR = 1.54,p = 0.007)的患者在住院期间的死亡风险较高,而未进行外科手术的患者的死亡风险较低(AHR = 4.48,p 结论:该研究强调了住院 CC 患者的死亡风险:本研究强调,住院的 CC 患者存活率较低,因此需要采取干预措施来改善护理,包括早期诊断策略和扩大获得资源充足的医疗服务的途径。
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Time to death from cervical cancer and its predictors in hospitalized patients: a survival approach study in Mato Grosso, Brazil.

Background: Cervical cancer (CC) is a serious public health concern, being the fourth most common cancer among women and a leading cause of cancer mortality. In Brazil, many women are diagnosed late, and in Mato Grosso, with its geographical diversity, there are specific challenges. This study analyzed hospital survival and its predictors using data from the Hospital Information System (SIH) of the Unified Health System (SUS) in Mato Grosso from 2011 to 2023.

Methods: Cox regression and Kaplan-Meier models were applied to determine survival time and identify mortality predictors. The adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was used to measure the association between the factors analyzed.

Results: The hospital mortality rate was 9.88%. The median duration of hospitalization was 33 days (interquartile range [IQR]: 12-36), with a median survival of 43.7%. Patients were followed up for up to 70 days. In the multivariable Cox model, after adjusting for potential confounders, the risk of death during hospitalization was higher in patients aged 40-59 years (AHR = 1.39, p = 0.027) and 60-74 years (AHR = 1.54, p = 0.007), in the absence of surgical procedures (AHR = 4.48, p < 0.001), in patients with medium service complexity (AHR = 2.40, p = 0.037), and in the use of ICU (AHR = 4.97, p < 0.001). On the other hand, patients with hospital expenses above the median (152.971 USD) showed a reduced risk of death (AHR = 0.21, p < 0.001).

Conclusion: This study highlights that hospitalized CC patients have reduced survival, underscoring the need for interventions to improve care, including strategies for early diagnosis and expanded access to adequately resourced health services.

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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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