Evaluation of four comorbidity indices and Charlson comorbidity index adjustment for colorectal cancer patients.
Int J Colorectal Dis
; 29(9): 1159-69, 2014 Sep.
Article
em En
| MEDLINE
| ID: mdl-25064390
ABSTRACT
INTRODUCTION:
Cancer survival is related not only to primary malignancy but also to concomitant nonmalignant diseases. The aim of this study was to investigate the prognostic capacity of four comorbidity indices [the Charlson comorbidity index (CCI), the Elixhauser method, the National Institute on Aging (NIA) and National Cancer Institute (NCI) comorbidity index, and the Adult Comorbidity Evaluation-27 (ACE-27)] for both cancer-related and all-cause mortality among colorectal cancer patients. A modified version of the CCI adapted for colorectal cancer patients was also built.METHODS:
The study population comprised 468 cases of colorectal cancer diagnosed between 1 January 2000 and 31 December 2010 at a community hospital. Data were prospectively collected and abstracted from patients' clinical records. Kaplan-Meier method and multivariate logistic regression models were performed for survival and risk of death analysis.RESULTS:
Only moderate or severe renal disease [hazard ratio (HR) 2.71, 95% confidence interval (CI) 1.11-6.63] and AIDS (HR 3.27, 95% CI 1.23-8.68) were independently associated with cancer-specific mortality, with a population attributable risk of 5.18 and 4.36%, respectively. For each index, the highest comorbidity burden was significantly associated with poorer overall survival (NIA/NCI HR 2.14, 95% CI 1.14-4.01; Elixhauser HR 1.98, 95% CI 1.09-1.42; ACE-27 HR 1.78, 95% CI 1.07-1.23; CCI HR 1.68, 95% CI 1.05-1.42) and cancer-specific survival. The modified version of the CCI resulted in a higher predictive power compared with other indices studied (cancer-specific mortality HR = 2.37, 95% CI 1.37-4.08).CONCLUSIONS:
The comorbidity assessment tools provided better prognostic prevision of prospective outcome of colorectal cancer patients than single comorbid conditions.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
Tipo de estudo:
Etiology_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article