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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32260


    標題: The age-adjusted Charlson comorbidity index is a better predictor of survival in operated lung cancer patients than the Charlson and Elixhauser comorbidity indices
    作者: Yang, Ching-Chieh
    Fong, Yao
    Lin, Li-Ching
    Que, Jenny
    Ting, Wei-Chen
    Chang, Chia-Li
    Wu, Hsin-Min
    Ho, Chung-Han
    Wang, Jhi-Joung
    Huang, Chung-I
    貢獻者: Chi Mei Med Ctr, Dept Radiat Oncol
    Natl Sun Yat Sen Univ, Inst Biomed Sci
    Chia Nan Univ Pharm & Sci, Dept Pharm
    Chi Mei Med Ctr, Dept Thorac Surg
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    E Da Canc Hosp, Dept Radiat Oncol
    關鍵字: Lung cancer
    Surgery
    Charlson comorbidity index
    Elixhauser comorbidity index
    age
    survival
    日期: 2018-01
    上傳時間: 2019-11-15 15:47:13 (UTC+8)
    出版者: OXFORD UNIV PRESS INC
    摘要: OBJECTIVES: To compare the prognostic performance between different comorbidity assessments of survival in patients with operated lung cancer. METHODS: A total of 4508 lung cancer patients treated by surgery between 2003 and 2012 were identified through Taiwan's National Health Insurance Research Database. Information on pre-existing comorbidities prior to the cancer diagnosis was obtained and adapted to the Charlson comorbidity index, age-adjusted Charlson comorbidity index (ACCI) and Elixhauser comorbidity index scores. The influence on survival was analysed using a Cox proportional hazard model. The discriminatory ability of the comorbidity indices were evaluated using Akaike information criterion and Harrell's C-statistic. RESULTS: The mean age of the study cohort was 64.95 +/- 11.15 years, and 56.28% of the patients were male. The median follow-up time was 2.59 years, and the 3-year overall survival was 73.94%. Among these patients, 2134 (47.3%) patients received adjuvant therapy. The Charlson comorbidity index and ACCI scores correlated well with survival and higher scores were associated with an increased 3-year mortality risk (hazard ratio = 1.21, 95% confidence interval = 1.03-1.42 and hazard ratio = 1.43, 95% confidence interval = 1.08-1.90, respectively) in multivariate analysis. The ACCI scores provided better discriminatory ability with a smaller Akaike information criterion and greater Harrell's C-statistic for 3-year overall survival compared to the Charlson comorbidity index or Elixhauser comorbidity index scores. CONCLUSIONS: The operated lung cancer patients with severe comorbidities were associated with worse survival. The ACCI appears to be a more appropriate prognostic indicator and should be considered for use in clinical practice.
    link: https://doi.org/10.1093/ejcts/ezx215
    關聯: Clinical Infectious Diseases, v.53, n.1, pp.235-240
    Appears in Collections:[藥學系(所)] 期刊論文
    [醫務管理系(所)] 期刊論文

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