The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study

Autor: Rafael Marcos-Gragera, Miguel Rodríguez-Barranco, María José Sánchez, Jose Exposito-Hernandez, Maja Niksic, Yoe-Ling Chang, Daniel Redondo-Sanchez, Joaquim Bosch-Barrera, Miguel Angel Luque-Fernandez, Ester Oliva-Poch
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMC Cancer, Vol 21, Iss 1, Pp 1-12 (2021)
Digibug. Repositorio Institucional de la Universidad de Granada
instname
BMC Cancer, 2021, vol. 21, p. 1048
Articles publicats (D-IMA)
DUGiDocs – Universitat de Girona
ISSN: 1471-2407
Popis: M.A.L.F. received support from the Instituto de Salud Carlos III, Madrid, Spain (grant/award no. CP17/00206-EU-FEDER). This work was supported by the Instituto de Salud Carlos III, Madrid, Spain [EU-FEDER-FIS PI-18/01593], the Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiologia y Salud Publica), the Cancer Epidemiological Surveillance Subprogram (VICA) from the Instituto de Salud Carlos III, Madrid, Spain, and the Andalusian Department of Health [PI-0152/2017]. The funders had no role in the design and conduct of the study, data collection, management, analysis, and interpretation of the data, the preparation, review, or approval of the manuscript or the decision to submit the manuscript for publication.
Aim: Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims to describe the prevalence and patterns of having one (comorbidity) or ≥ 2 chronic diseases (multimorbidity) among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and short-term mortality risk at six months after cancer diagnosis. Methods: In this population-based cohort study, data were drawn from two Spanish population-based cancer registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients, diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex, smoking status, province of residence, surgery, cancer stage, histology, and body mass index. Results: We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men, those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities were chronic obstructive pulmonary disease (36.6%), diabetes (20.7%) and heart failure (16.8%). The strongest pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40% higher overall mortality risk than those without comorbidities (aHR for comorbidity: 1.4, 95%CI: 1.1–1.7; aHR for multimorbidity: 1.4, 95%CI: 1.1–1.8), when relevant confounding factors were considered. Conclusions: The presence of comorbid diseases, rather than the number of comorbidities, was associated with increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients with one or more comorbidities in Spain.
Instituto de Salud Carlos III CP17/00206-EU-FEDER EU-FEDER-FIS PI-18/01593
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiologia y Salud Publica)
Cancer Epidemiological Surveillance Subprogram (VICA) from the Instituto de Salud Carlos III, Madrid, Spain
Andalusian Department of Health PI-0152/2017
Databáze: OpenAIRE
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