Improving outcome prediction in individuals with colorectal cancer and diabetes by accurate assessment of vascular complications: Implications for clinical practice
| Autor: | Eva Morris, Amy Downing, P. J. Finan, Ramzi A. Ajjan, Rebecca J. Birch, Simon J. Howell |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Population 03 medical and health sciences Postoperative Complications 0302 clinical medicine 030202 anesthesiology Internal medicine Diabetes mellitus Humans Medicine 030212 general & internal medicine Risk factor education Aged Aged 80 and over Diabetes Complication education.field_of_study business.industry Cancer General Medicine Middle Aged medicine.disease Comorbidity Oncology Female Surgery Colorectal Neoplasms business Complication Diabetic Angiopathies |
| Zdroj: | European Journal of Surgical Oncology. 47:999-1004 |
| ISSN: | 0748-7983 |
| Popis: | Background: Diabetes is considered a risk factor for mortality following a diagnosis of cancer. We hypothesised that the risk will vary due to the heterogeneous nature of the population and accurate classification of vascular complications will improve prediction of clinical outcomes. Methods: The COloRECTal cancer data Repository (CORECT-R) was used to identify individuals with primary colorectal cancer, who underwent surgical resection in England (2005–2016). Diabetes was recorded using ICD10 codes (E10-E14) during inpatient hospital admission in the six years preceding cancer diagnosis, complication status was determined using the adapted Diabetes Complications Severity Index (aDCSI). Survival and post-operative outcomes were compared between groups. Results: Of 232,367 individuals, 28,642 (12.3%) were recorded as having diabetes, 49.2% of whom had complications according to the aDCSI. Patients with diabetes complications had increased incidence of adverse post-operative outcomes (90-day post-operative mortality (6.6% versus 3.2%) and death during the surgical episode (7.9% versus 3.6%)), compared to those without diabetes. Those without complications had rates comparable to the population without diabetes. The odds of death within a year of diagnosis were higher for those with complicated diabetes compared to those without diabetes [OR 1.58 (95%CI 1.51–1.66) p |
| Databáze: | OpenAIRE |
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