Development of a new head and neck cancer-specific comorbidity index
Development of a new head and neck cancer-specific comorbidity index
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DOI：
10.1001/archotol.128.10.1172
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发表时间：
2002-10-01
影响因子：
--
通讯作者：
Spitznagel, EL
中科院分区：
文献类型：
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作者：
Piccirillo, JF;Lacy, PD;Spitznagel, EL
背景：大多数头颈部鳞状细胞癌患者年龄较大，可能合并或合并疾病。目的：确定个体共病对头颈癌患者预后的影响，结合个体共病形成一种新的头颈部特异性共病工具，并将其与改良的Kaplan-Feinstein指数进行比较，以确定新的疾病特异性工具是否提供了比一般共病指数更好的生存预测。设计：回顾医疗记录。人口：研究人群包括1153名经活检证实的新诊断的口腔、口咽部鳞状细胞癌患者，结果：7种并存疾病(充血性心脏病、心律失常、周围血管疾病、肺部疾病、肾脏疾病、癌症控制和癌症未控制)与生存显著相关。这些共病情况被分配了整数权重，以反映它们相对预后的重要性，并结合起来创建了新的华盛顿大学头颈部共病指数(WUHNCI)。存活率与WUHNCI定义的合并症严重程度显著相关。WUHNCI对生存率的预测优于改良的Kaplan-Feinstein指数，尽管其包含的疾病要少得多。结论：共病是头颈癌患者的一个重要特征。WUHNCI可用于回顾回顾或前瞻性结果研究。
Background: Most patients with head and neck squamous cell carcinoma are older and may have coexistent or comorbid diseases.Objectives: To determine the prognostic impact of individual comorbid conditions in patients with head and neck cancer, to combine the individual comorbid conditions to form a new a head and neck-specific comorbidity instrument, and to compare it with the Modified Kaplan-Feinstein Index to determine if the new disease-specific instrument offers any improvement in survival prediction over a general comorbidity index.Design: Retrospective review of medical records.Population: The study population comprised 1153 patients with biopsy-proven, newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, or larynx.Results: Seven comorbid conditions (congestive heart disease, cardiac arrhythmia, peripheral vascular disease, pulmonary disease, renal disease, cancer controlled, and cancer uncontrolled) were significantly related to survival. These comorbid conditions were assigned integer weights to reflect their relative prognostic importance and combined to create the new Washington University Head and Neck Comorbidity Index (WUHNCI). Survival was significantly related to levels of comorbidity severity as defined by the WUHNCI. The WUHNCI predicted survival better than the Modified Kaplan-Feinstein Index despite containing far fewer ailments.Conclusions: Comorbidity is an important feature of the patient with head and neck cancer. The WUHNCI can be used for retrospective review or prospective outcomes research.