Lattice Boltzmann mesoscopic study of effects of corrosion on flow boiling heat transfer in microchannels

被引:2
|
作者
Kuryba, A. J. [1 ,2 ,7 ]
Boyle, J. M. [1 ,2 ]
van der Meulen, J. [1 ,2 ]
Aggarwal, A. [2 ,3 ]
Walker, K. [1 ,2 ]
Fearnhead, N. S. [4 ]
Braun, M. S. [5 ,6 ]
机构
[1] Royal Coll Surgeons England, Clin Effectiveness Unit, London, England
[2] London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, England
[3] Guys & St Thomas NHS Fdn Trust, Dept Oncol, London, England
[4] Cambridge Univ Hosp NHS Fdn Trust, Dept Colorectal Surg, Cambridge, England
[5] Christie NHS Fdn Trust, Dept Oncol, Manchester, England
[6] Univ Manchester, Sch Med Sci, Manchester, England
[7] Royal Coll Surgeons England, Clin Effectiveness Unit, 38-43 Lincolns Inn Fields, London WC2A 3PE, England
关键词
Key words; Activities of daily living; colorectal neoplasms; dementia; patient care; prognosis; OLDER PATIENTS; COLON-CANCER; DEMENTIA; DIAGNOSIS; SURVIVAL; CARE; PREDICTORS; OUTCOMES; PEOPLE; ADULTS;
D O I
10.1016/j.clon.2022.08.035
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aims: There is little evidence about the survival of patients with colorectal cancer (CRC) also diagnosed with dementia. We quantified dementia severity and estimated how it is associated with 2-year overall survival.Materials and methods: Records of patients aged 65 years or older diagnosed with CRC in England and Wales were identified. A novel proxy for dementia severity combined dementia diagnosis in administrative hospital data with Eastern Cooperative Oncology Group performance status. Cox regression was used to estimate hazard ratios with and without risk adjustment.Results: In total, 4033 of 105 250 CRC patients (3.8%) had dementia recorded. Two-year survival decreased with increasing dementia severity from 65.4% without dementia, 53.5% with mild dementia, 33.0% with moderate dementia to 16.5% with severe dementia (hazard ratio comparing severe with no dementia: 2.97; 95% confidence interval 2.79, 3.16). Risk adjustment for comorbidity and cancer stage reduced this association slightly (hazard ratio 2.52; 95% confidence interval 2.37, 2.68) and additional adjustment for treatment factors reduced it further (hazard ratio 1.60; 95% confidence interval 1.50, 1.70).Conclusions: Survival of CRC patients varied strongly according to dementia severity, suggesting that a 'one-size-fits-all' policy for the care of CRC patients with dementia is not appropriate. Comprehensive assessment of cancer patients with dementia that considers dementia severity is essential in a shared decision-making process that ensures patients receive the most appropriate treatment for their individual needs and preferences.(c) 2022 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:E67 / E76
页数:10
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