ASSOCIATION BETWEEN SURGICAL VOLUME AND MORTALITY FROM COLON CANCER IN COLOMBIA: A NATIONAL COHORT

被引:0
|
作者
Castro-cuaran, Maria Fernanda [1 ,2 ]
Junca, Edgar German [1 ,2 ]
Gonzalez-patino, Diego Felipe [1 ]
Buitrago, Does Giancarlo [1 ,2 ,3 ]
机构
[1] Univ Nacl Colombia, Fac Med, Dept Surg Bogota, Bogota, DC, Colombia
[2] Hosp Univ Nacl Colombia, Dept Surg, Bogota, DC, Colombia
[3] Univ Nacl Colombia, Clin Res Inst, Fac Med, Bogota, DC, Colombia
关键词
Colonic neoplasms; Colectomy; Survival; Mortality; Cohort studies; CLINICAL-PRACTICE GUIDELINES; COLORECTAL-CANCER; SPECIALITY; CASELOAD; SURVIVAL; SURGERY; IMPACT; CALI;
D O I
10.1590/0102-6720202400041e1835
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
- BACKGROUND: Colon cancer is the third most common malignancy in Colombia, only Fabricio Ferreira 3 , Paulo 3 exceeded by prostate and breast cancers. It is the second most common cancer among females and the third most common among males. The epidemiology of this disease has changed in Colombia, and its peak incidence has now surpassed that of gastric cancer. AIMS: We aimed to determine the- Racional: O tratamento de escolha para pacientes com hipertens & atilde;o portal association between hospital surgical volume and mortality in patients with colon cancer undergoing esquistossom & oacute;tica com sangramento de varizes & eacute; a desconex & atilde;o & aacute;zigo-portal mais surgical resection in Colombia. METHODS: This was a national retrospective cohort study based on administrative data and included adult patients undergoing surgical resection for colon cancer who esplenectomia (DAPE) associada u terapia endosc & oacute;pica. Por & eacute;m, estudos mostram aumento were enrolled in Colombia's contributory health system between 2012 and 2017. We defined exposure do calibre das varizes em alguns pacientes durante o seguimento em longo prazo. Objetivo: as the hospital's surgical volume where the colon cancer surgery was performed. We classified the Avaliar o impacto da DAPE e tratamento endosc & oacute;pico p & oacute;s-operat & oacute;rio no comportamento patients as exposed to a high surgical volume (above the 90th percentile of the provider distribution) das varizes esof & aacute;gicas e recidiva hemorr & aacute;gica, de pacientes esquistossom & oacute;ticos. M & eacute;todos: and a low surgical volume (under the 90th percentile). The main outcomes were 30-day and 1-year Foram estudados 36 pacientes com seguimento superior a cinco anos, distribu & iacute;dos em mortality. Multivariate Poisson regressions were used to identify the association between exposure and mortality rates.RESULTS: The study included 4,647 patients, of which 4,188 underwent surgery at dois grupos: queda da press & atilde;o portal abaixo de 30% e acima de 30% comparados como hospitals with a colectomy volume lower than 33 per year and 459 underwent surgery at institutions calibre das varizes esof & aacute;gicas no p & oacute;s-operat & oacute;rio precoce e tardio al & eacute;m do & iacute;ndice de recidiva with volumes equal to or higher than 33 per year. In the multivariate analysis, after adjusting for hemorr & aacute;gica. Resultados observable variables, a lower risk of 30-day mortality was found in patients who underwent surgery esof & aacute;gicas que, durante o seguimento aumentaram de calibre e foram controladas com at high surgical volume institutions (relative risk - RR 0.57, 95% confidence interval - 95%CI 0.033- 0.97). No differences were found in the one-year mortality. CONCLUSION: The high surgical volume of a hospital is associated with a 30-day mortality in colon cancer, as described in other studies, but o comportamento do calibre das varizes no p & oacute;s-operat & oacute;rio precoce nem tardio nem os the 1-year mortality did not show this association. Prospective studies are required to establish a & iacute;ndices de recidiva hemorr & aacute;gica. Conclus & atilde;o causal relationship.
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