PO.PS01.05 · 人群科学
肝胆和胰腺癌患者死亡率的预测因素
Predictors of mortality in patients with hepatobiliary and pancreatic cancers
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：肝胆和胰腺癌是最致命的恶性肿瘤，由于诊断延迟和治疗选择有限，生存结局始终不佳。识别与死亡率相关的因素对于改善预后和量身定制支持性照护至关重要。然而，关于该人群死亡率综合预测因素的证据仍然有限。本研究旨在采用一种纳入人口学、临床、实验室和心理因素（包括生活质量QoL）的生物-心理-社会方法，识别死亡率的决定因素。
方法：2022年9月至2023年11月期间从一所大学医院招募诊断为肝胆或胰腺癌的患者，自入组起随访其1年死亡情况。分别使用数字评定量表、医院焦虑抑郁量表和癌症治疗功能评估-通用量表评估疼痛、焦虑、抑郁和QoL。临床信息和死亡记录取自电子健康记录。采用Cox比例风险回归，使用SPSS 30.0识别影响死亡率的因素。
结果：在204名参与者中，204名参与者中记录了81例（39.7%）死亡。较高的身体健康状况（HR=0.95，95% CI：0.90, 0.99）和接受癌症手术治疗（HR=0.38，95% CI：0.21, 0.70）与较低的死亡率相关。相反，较高的社会健康状况预示死亡率增加（HR=1.12，95% CI：1.06, 1.19），这可能表明晚期疾病患者获得了更多的社会支持和照护。血尿素氮升高也预示较高的死亡率（HR=1.03，95% CI：1.01, 1.07），提示代谢负担或肾功能障碍会恶化结局。
结论：身体健康状况、接受手术治疗和血尿素氮水平是肝胆和胰腺癌患者死亡率的显著预测因素。增强身体功能、手术治疗史和监测代谢指标可能改善预后评估。而除QoL外的心理因素并未直接预测死亡率。这些发现凸显了整合的生物-心理-社会方法对于管理高风险癌症人群的价值。
查看英文原文 English abstract
Background Hepatobiliary and pancreatic cancers are the most lethal malignancies, with consistently poor survival outcomes due to delayed diagnosis and limited therapeutic options. Identifying factors associated with mortality is essential for improving prognosis and tailoring supportive care. However, evidence remains limited regarding comprehensive predictors of mortality in this population. This study aimed to identify determinants of mortality using a biopsychosocial approach that incorporates demographic, clinical, laboratory, and psychological factors, including quality of life (QoL).
Methods Patients diagnosed with hepatobiliary or pancreatic cancers were recruited from a university hospital between September 2022 and November 2023, and their mortality was followed up at 1 year from enrollment. Pain, anxiety, depression, and QoL were assessed using the Numeric Rating Scale, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-General, respectively. Clinical information and death records were obtained from electronic health records. Cox proportional hazards regression was performed to identify factors influencing mortality using SPSS 30.0.
Results Among the 204 participants, Among the 204 participants, 81 (39.7%) of deaths were recorded. Higher physical well-being (HR = 0.95, 95% CI: 0.90, 0.99) and undergoing surgical treatment for cancer (HR = 0.38, 95% CI: 0.21, 0.70) were associated with lower mortality. In contrast, higher social well-being predicted increased mortality (HR = 1.12, 95% CI: 1.06, 1.19), which may indicate that patients with advanced disease receive more social support and caregiving. Elevated blood urea nitrogen also predicted higher mortality (HR = 1.03, 95% CI: 1.01, 1.07), suggesting that metabolic burden or renal dysfunction worsens outcomes.
Conclusions Physical well-being, received surgical treatment, and blood urea nitrogen levels were significant predictors of mortality in patients with hepatobiliary and pancreatic cancers. Enhancing physical functioning, surgical treatment history, and monitoring metabolic indicators may improve prognostic assessment. While psychological factors, except QoL, did not directly predict mortality. The findings highlight the value of an integrated biopsychosocial approach for managing high-risk cancer populations.
利益披露 Disclosure
J. Lee, None..
S. Hwang, None..
S. Hwang, None..
J. Kim, None.