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Evaluation of four comorbidity indices and Charlson comorbidity index adjustment for colorectal cancer patients.

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.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Marventano S,Grosso G,Mistretta A,Bogusz-Czerniewicz M,Ferranti R,Nolfo F,Giorgianni G,Rametta S,Drago F,Basile F,Biondi A

doi

10.1007/s00384-014-1972-1

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

1159-69

issue

9

eissn

0179-1958

issn

1432-1262

journal_volume

29

pub_type

杂志文章

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