摘要
目的分析老年恶性肿瘤患者的临床特点并探讨死亡相关危险因素。方法回顾性调查2010年1月至2012年12月收住肿瘤内科干部病区的老年恶性肿瘤患者的临床资料,根据观察终点分为死亡组和存活组,采用倾向性评分法匹配2组间年龄和原发肿瘤差异。对2组合并感染、贫血、高尿酸血症、低蛋白血症、高血压、冠心病、慢性肾功能不全(CRF)、糖尿病、高胆红素血症、高脂血症、慢性阻塞性肺疾病(COPD)等因素进行比较,并对死亡相关危险因素进行多因素Logistic回归分析。结果共纳入339例老年恶性肿瘤患者,采用倾向性评分法匹配后,死亡组32例,存活组106例;原发肿瘤构成依次为肺癌、消化系统肿瘤、血液系统肿瘤和其他来源肿瘤。死亡组合并感染、贫血、高尿酸血症的发生率分别为86.7%、80.1%和79.4%,较存活组差异均有统计学意义;死亡组血红蛋白和尿酸水平分别为(87.2±25.5)g/L、和(471.8±184.3)μmol/L,较存活组差异均有统计学意义。多因素Logistic回归分析显示,死亡相关危险因素为合并感染和贫血。结论老年恶性肿瘤患者合并感染、贫血、高尿酸血症发生率高,其中感染和贫血是患者死亡的危险因素。
Objective To clarify clinical characteristics and investigate the death related risk factors of elderly pa- tients with cancer. Methods Retrospective analysis was used to collect the clinical features of elderly patients with cancer acquired in our center from January 2010 to December 2012. Patients were categorized into 2 groups according to survival prognosis. Propensity score was used to match age and primary diseases. The incidence rates of infection, anemia, hyperuricemia, hypoalbuminemia, hypertension, coronary heart disease, chronic renal failure, diabetes mellitus, hyperbil- irubinemia, hyperlipemia and chronic obstructive pulmonary disease between the two groups were compared. Logistic multi- variate regression analysis was conducted to determine the risk factors. Results A total of 339 patients were included in the study. The participants were divided into death group （n= 32） and survival group （n= 106）. Primary diseases were lung carcinoma, digestive system neoplasms, hematological system neoplasms and other system neoplasms by turns. The in- cidences of infection, anemia and hyperuricemia in death group were 86. 7%, 80. 1% and 79. 4% respectively, which were significantly different from those in survival group. Levels of hemoglobin and uric acid in death group were （87. 2＋25.5） g/L and （471.8＋ 184. 3） μmol/L, respectively, which were significantly different from those in survival group. The regres- sion analysis suggested that infection and anemia were closely related to death. Conclusions Infection, anemia and hy- peruricemia are common among eldlery patients with cancer. The risk factors related to death in elderly patients with cancer are infection and anemia.
出处
《实用老年医学》
CAS
2014年第4期281-283,286,共4页
Practical Geriatrics
