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首页> 外文期刊>Thorax: The Journal of the British Thoracic Society >Association between age, deprivation and specific comorbid conditions and the receipt of major surgery in patients with non-small cell lung cancer in England: A population-based study
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Association between age, deprivation and specific comorbid conditions and the receipt of major surgery in patients with non-small cell lung cancer in England: A population-based study

机译：年龄，剥夺和特定合并症的关联以及英格兰非小细胞肺癌患者的主要手术接收：基于人群的研究

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Introduction We investigated socioeconomic disparities and the role of the main prognostic factors in receiving major surgical treatment in patients with lung cancer in England. Methods Our study comprised 31 351 patients diagnosed with non-small cell lung cancer in England in 2012. Data from the national population-based cancer registry were linked to Hospital Episode Statistics and National Lung Cancer Audit data to obtain information on stage, performance status and comorbidities, and to identify patients receiving major surgical treatment. To describe the association between prognostic factors and surgery, we performed two different analyses: one using multivariable logistic regression and one estimating cause-specific hazards for death and surgery. In both analyses, we used multiple imputation to deal with missing data. Results We showed strong evidence that the comorbidities 'congestive heart failure', 'cerebrovascular disease' and 'chronic obstructive pulmonary disease' reduced the receipt of surgery in early stage patients. We also observed gender differences and substantial age differences in the receipt of surgery. Despite accounting for sex, age at diagnosis, comorbidities, stage at diagnosis, performance status and indication of having had a PET-CT scan, the socioeconomic differences persisted in both analyses: more deprived people had lower odds and lower rates of receiving surgery in early stage lung cancer. Discussion Comorbidities play an important role in whether patients undergo surgery, but do not completely explain the socioeconomic difference observed in early stage patients. Future work investigating access to and distance from specialist hospitals, as well as patient perceptions and patient choice in receiving surgery, could help disentangle these persistent socioeconomic inequalities.
机译：介绍我们调查了社会经济差异和主要预后因素在英格兰肺癌患者接受主要手术治疗方面的作用。方法采用2012年患有3151例患有非小细胞肺癌的3151名患者。基于国家人口的癌症登记处的数据与医院发作统计和国家肺癌审计数据有关，以获取有关阶段，业绩状况和绩效状况的信息同血症，并鉴定接受主要手术治疗的患者。为了描述预后因素和手术之间的关联，我们进行了两种不同的分析：一种使用多变量逻辑回归和一个估算死亡和手术的造成特异性危害。在这两种分析中，我们使用多个贷款来处理缺失的数据。结果我们表现出强烈的证据表明，在早期患者的手术中，合并症“充血性心力衰竭”，“脑血管疾病”和“慢性阻塞性肺病”。我们还观察到在接收手术中的性别差异和大量的年龄差异。尽管对性别进行了核算，但在诊断的年龄，诊断，阶段阶段，具有PET-CT扫描的绩效状况和指示，均在分析中持续存在的社会经济差异：早期贫困人员早期接受手术的可能性较低和较低率阶段肺癌。讨论合并症在患者是否经过手术中发挥着重要作用，但在早期患者中没有完全解释观察到的社会经济差异。未来的工作调查从专家医院的访问和距离以及接受手术中的患者看法和患者选择可以帮助解开这些持久的社会经济不平等。

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