非小细胞肺癌患者生存时间与住院费用的关联性分析  

Association study of survival time and hospitalization expenses in patients of non-small cell lung cancer

作　　者：顾晓芳[1,2] 蔡敏[1] 陈峰[1] 

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]江苏省肿瘤医院病案统计室,江苏南京210009

出　　处：《中华肿瘤防治杂志》2013年第5期330-333,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：江苏省自然科学基金(BK2008449)

摘　　要：目的:分析非小细胞肺癌(NSCLC)患者生存时间与住院费用之间是否存在一定的关联性。方法:回顾性调查收集2003-01-01-2007-12-30初次入院接受治疗,有较完整病案资料、费用信息和死亡时间的94例NSCLC患者,运用Cox比例风险模型建立单因素和多因素模型,分析住院费用与生存时间的相关性。结果:94例NSCLC患者中位生存时间为14个月。12、24和36个月的生存率分别为54.3%、24.5%和9.6%。单因素分析结果显示,临床分期、治疗前血小板水平、治疗前肺功能状况、治疗前KPS评分、付款方式和治疗方式等因素与生存时间相关,日均住院费用对生存时间也有影响,HR=0.482,P=0.008。多因素Cox回归分析结果显示,住院总费用(HR=0.995,P=0.112)、平均每次住院费用(HR=1.004,P=0.457)和每天住院费用(HR=0.563,P=0.078)对生存时间的影响均差异无统计学意义。结论:NSCLC患者住院全过程中,在调整与生存预后有关的各因素影响后,其住院费用与生存时间不存在相关性,临床上治疗NSCLC应该注意制定合理的诊疗方案,防止过度医疗和不合理用药。OBJECTIVE： To evaluate the association between survival time and hospitalization expenses of patients with non-small cell lung cancer （NSCLC）. METHODS： A total of 94NSCLC patients treated in hospital for the first time from January 1,2003 to Decemeber 30,2007 with complete clinical medical records, hospitalization expenses information and death time were collected for retrospective study. Univariate and multivariate Cox proportional hazard models were es- tablished to analyze the relationship between survival time and hospitalization expenses. RESULTS： The median survival time of the 94 patients was 14 months. 1-year, 2-year and 3-year survival rate was 54.3 %, 24.5 % and 9.6 %, respectively. The univariate Cox regression analysis showed that clinical staging, PLT level, PF status, KPS scoring before treatment, payment method, chemotherapy and surgical treatment were related with survival time. Hospitalization expenses of per day significantly influenced survival time of NSCLC （HR= 0. 482, P-= 0.008）. Multivariate cox regression analysis suggested that total hospitalization expenses （HR = 0. 995, P = 0, 112）, hospitalization expenses of per time （HR = 1. 004, P = 0. 457） and hospitalization expenses of per day （HR= 0. 563,P= 0. 078） all had no significant statistical influence to the survival time of NSCLC after adjusting the covariates. CONCLUSIONS： The study indicates that therCs no association be- tween survival time and hospitalization expenses in the patients with NSCLC after adjusting the possible factors of progno- sis and survival. Clinical treatment of NSCLC patients should pay attention to provide rational treatment plans and to avoid overtreatment.

关 键 词：非小细胞肺癌 生存分析 COX比例风险模型 住院费用 

分 类 号：R734.2[医药卫生—肿瘤]