癌症主要是衰老的疾病,老年癌症患者通常更虚弱。这项研究旨在描述特点和住院结局,并探讨与持续时间相关的因素。成本,以及首次住院期间的死亡率,在中国顶级医院收治的老年癌症患者中。
从上海瑞金医院电子病历中检索2016-2020年连续住院≥65年的实体癌患者数据,中国。基线特征,持续时间,成本,并对住院期间的死亡率进行了描述。与持续时间相关的因素,成本,首次住院期间的死亡率采用多变量校正逻辑回归分析.
分析了20,650名男性比例为59%,中位年龄为70岁的合格患者。45%的患者在我院行手术切除。第一次入院时,49%的患者有高血压,19%糖尿病,22%的重量损失,和28%的营养不良风险。首次住院的中位持续时间和费用为9天和32,000元人民币,分别。在首次住院和任何住院期间发生了118例(0.6%)和228例(1.1%)死亡。分别。第一次住院,较长的持续时间和较高的成本与年龄呈正相关,男性,紧急入院,某些肿瘤位置和组织学,糖尿病史,肝硬化,和抗凝剂的摄入量,较高的体重指数,减肥,减少食物摄入,跌倒的风险,自我护理能力较差;院内死亡率与年龄≥85岁呈正相关,紧急入院,某些癌症类型,高血压和精神药物摄入史,减少食物摄入,自理能力更差。
这项研究确定了某些基线患者和肿瘤特征,医疗和用药史,体重和食物摄入量的变化,饮食,和自我护理能力与住院老年癌症患者的住院结局独立相关,应给予特别关注。虽然这些因素可能不容易修改,我们的研究可以帮助识别住院结局较差风险较高的患者.
Cancer is mostly a disease of aging, and older patients with cancer are generally frailer. This study aimed to describe the characteristics and in-hospital outcomes and explore factors associated with duration, cost, and mortality during first hospitalization, in older patients with cancer admitted to a top-ranked hospital in
China.
Data on patients with solid cancer ≥65 years consecutively hospitalized in 2016-2020 were retrieved from the electronic medical records of Ruijin Hospital in Shanghai,
China. Baseline characteristics, duration, cost, and mortality during hospitalization were described. Factors associated with duration, cost, and mortality during first hospitalization were explored using multivariable-adjusted logistic regression.
20,650 eligible patients with male proportion of 59% and median age of 70 years were analyzed. 45% of the patients underwent resection in our hospital. Upon first admission, 49% of patients had hypertension, 19% diabetes, 22% weight loss, and 28% risks of malnutrition. The median duration and cost of first hospitalization were 9 days and 32,000 RMB, respectively. 118 (0.6%) and 228 (1.1%) deaths occurred during first and any hospitalization, respectively. For first hospitalization, longer duration and higher cost were positively associated with older ages, male gender, emergency admission, certain tumor locations and histology, histories of diabetes, cirrhosis, and anticoagulant intake, higher body mass index, weight loss, reduced food intake, risk of falling, and worse self-care ability; in-hospital mortality was positively associated with age ≥85 years, emergency admission, certain cancer types, histories of hypertension and psychotropic intake, reduced food intake, and worse self-care ability.
This study identified certain baseline patient and tumor characteristics, medical and medication histories, changes of weight and food intake, diet, and self-care ability which were independently associated with in-hospital outcomes among older patients with cancer admitted to our hospital and which should be paid special attention to. While the factors might not be easily modifiable, our study can help identify patients at higher risks of inferior in-hospital outcomes.