Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation
Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation
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DOI：
10.1200/jco.2001.19.8.2201
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发表时间：
2001-04-15
影响因子：
45.3
通讯作者：
Horowitz, M
中科院分区：
文献类型：
--
作者：
Sonis, ST;Oster, G;Horowitz, M
目的：探讨口腔粘膜炎与血液和骨髓移植患者的选定临床和经济结果之间的关系。 患者和方法：受试者由来自八个中心的 92 名移植患者组成，他们参加了一项新的口腔粘膜炎评分系统（口腔粘膜炎评估量表 [OMAS]）的跨国试点研究。在试点研究中，从调理的第一天开始评估患者的红斑和溃疡/假膜形成情况，并持续 28 天。我们检查了患者的 OMAS 峰值评分与发烧天数（体温 > 38.0 摄氏度）、显着感染的发生情况、全肠外营养 (TPN) 天数、注射麻醉药治疗天数（超过 28 天）、住院天数（60 天）、入院指数总住院费用以及 100 天生命状态之间的关系。 结果：患者的 OMAS 峰值评分跨越了所有可能值范围（0 到5) 并且与所有感兴趣的结果显着相关 (P < .05)，发烧天数除外 (P = .21)。在控制移植物类型（同义异体 v 同种异体）和研究中心的分析中，峰值 OMAS 评分增加 1 分与以下因素相关：(1) 发烧增加 1.0 天 (P < .01)，(2) 严重感染风险增加 2.1 倍 (P < .01)，(3) TPN 增加 2.7 天 (P < .0001)，(4) 注射剂增加 2.6 天麻醉治疗 (P < .0001)，(5) 住院时间增加 2.6 天 (P < .01)，(6) 额外住院费用 25,405 美元 (P < .0001)，以及 (7) 100 天死亡风险增加 3.9 倍 (P < .01)。与没有溃疡的患者相比，有溃疡证据的患者平均住院费用高出 42,749 美元 (P = .06)。结论：口腔粘膜炎与血液和骨髓移植的临床和经济结果显着较差相关。 (C) 2001 年美国临床肿瘤学会。
Purpose: To explore the relationship between oral mucositis and selected clinical and economic outcomes in blood and marrow transplant patients.Patients and Methods: Subjects consisted of 92 transplant patients from eight centers who participated in a multinational pilot study of a new oral mucositis scoring system (Oral Mucositis Assessment Scale [OMAS]). In the pilot study, patients were evaluated for erythema and ulceration/pseudomembrane formation beginning on the first day of conditioning and continuing for 28 days. We examined the relationship between patients' peak OMAS scores and days with fever (body temperature > 38.0 degreesC), the occurrence of significant infection, days of total parenteral nutrition (TPN), and days of injectable narcotic therapy tall over 28 days), days in hospital lover 60 days), total hospital charges for the index admission, and vital status at 100 days.Results: Patients' peak OMAS scores spanned the full range of possible values (0 to 5) and were significantly (P < .05) correlated with all of the outcomes of interest except days with fever (P = .21). In analyses controlling for type of graft tautologous v allogeneic) and study center, a 1-point increase in peak OMAS score was associated with (1) 1.0 additional day with fever (P < .01), (2) a 2.1-fold increase in risk of significant infection (P < .01), (3) 2.7 additional days of TPN (P < .0001), (4) 2.6 additional days of injectable narcotic therapy (P < .0001), (5) 2.6 additional days in hospital (P < .01), (6) $25,405 in additional hospital charges (P < .0001), and (7) a 3.9-fold increase in 100-day mortality risk (P < .01). Mean hospital charges were $42,749 higher among patients with evidence of ulceration compared with those without (P = .06).Conclusion: Oral mucositis is associated with significantly worse clinical and economic outcomes in blood and marrow transplantation. (C) 2001 by American Society of Clinical Oncology.