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首页> 外文期刊>Gut: Journal of the British Society of Gastroenterology >Variation in gastroscopy rate in English general practice and outcome for oesophagogastric cancer: Retrospective analysis of Hospital Episode Statistics
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Variation in gastroscopy rate in English general practice and outcome for oesophagogastric cancer: Retrospective analysis of Hospital Episode Statistics

机译：食管胃癌的英国一般实践中胃镜检查率的变化和结局：医院发作统计资料的回顾性分析

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Objective: To determine whether variation in gastroscopy rates in English general practice populations is associated with inequality in oesophagogastric (OG) cancer outcome. Design: Retrospective observational study of the Hospital Episode Statistics (HES) dataset for England (2006-2008) linked to death registration. Methods: were validated using independent local and national data. General practices with new cases of OG cancer were included. Practices were grouped into tertiles according to standardised elective gastroscopy rate per capita (low, medium or high). Outcome measures for cancer cases were: emergency admission during diagnostic pathway, major surgical resection and mortality at 1 year. Covariates were: age group, gender, comorbidity, general practice average deprivation and patient deprivation. Results: 22 488 incident cases of OG cancer from 6513 general practices were identified. Patients registered with the low tertile group of practices had the lowest rate of major surgery, highest rate of emergency admission and highest mortality. The inequality was widest for the most socioeconomically deprived cases. After adjustment for covariates in logistic regression, the gastroscopy rate (low, medium or high) at the patient's general practice was an independent predictor of emergency admission, major surgery and mortality. Conclusions: There is wide variation in the rate of gastroscopy among general practice populations in England. On average, OG cancer patients belonging to practices with the lowest rates of gastroscopy are at greater risk of poor outcome. These findings suggest that initiatives or current guidelines aimed at limiting the use of gastroscopy may adversely affect cancer outcomes.
机译：目的：确定英国普通人群中胃镜检查率的变化是否与食管胃癌（OG）癌预后不平等相关。设计：与死亡登记相关的英格兰（2006-2008年）医院病情统计（HES）数据集的回顾性观察研究。方法：使用独立的本地和国家数据进行验证。包括新的OG癌症病例的一般做法。根据人均标准选择性胃镜检查率（低，中或高），将实践分组为三分位数。癌症病例的结局指标为：诊断途径中紧急入院，大手术切除和1年死亡率。协变量为：年龄组，性别，合并症，全科平均剥夺和患者剥夺。结果：从6513例常规操作中鉴定出22 488例OG癌症事件病例。注册低三分位数实践组的患者大手术率最低，急诊入院率最高，死亡率最高。对于社会经济最贫困的情况，不平等现象最为严重。在对逻辑回归的协变量进行调整之后，患者的一般实践中的胃镜检查率（低，中或高）是紧急入院，大手术和死亡率的独立预测指标。结论：在英国普通人群中，胃镜检查率存在很大差异。平均而言，属于胃镜检查率最低的实践的OG癌症患者发生不良结果的风险更大。这些发现表明，旨在限制胃镜检查的使用的倡议或当前指南可能会对癌症结果产生不利影响。

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