结直肠癌患者年龄与住院流程的关系:基于DACCA的真实世界数据研究  

Relationship between age of patients with colorectal cancer and hospitalization process:a real world study based on DACCA

作　　者：周嘉茗 陈希 林容若[1,2] 汪晓东 李立[1] ZHOU Jiaming;CHEN Xi;LIN Rongruo;WANG Xiaodong;LI Li(Division of Gastrointestinal Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine in Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院普外科,胃肠外科病房,成都610041 [2]四川大学华西临床医学院,成都610041

出　　处：《中国普外基础与临床杂志》2022年第8期1073-1077,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省科技厅重点研发项目(项目编号:2021YFS0112);四川大学大学生创新创业项目(项目编号:20221159L)。

摘　　要：目的分析目前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中,华西医院作为区域性中心所服务的结直肠患者人群的年龄对住院流程的影响。方法本次数据分析选取的DACCA版本为2022年1月5日更新版,其中分析的数据项目包括:年龄、入院日期、手术日期、出院日期、术前住院时间、术后住院时间、住院总时间及管理流程,并按年龄分为≤45(年轻组)、46~64(中年组)及≥65岁(老年组)3个年龄段。结果按照条件筛选DACCA数据库,获得8013条可分析数据行,数据涵盖2005–2022年。患者的年龄为14~104岁、(58.01±13.52)岁。年龄特征性分析结果显示:年龄与术后住院时间的关系无统计学意义(P>0.05),但是术前住院时间(P=0.001)和总住院时长(P=0.005)与年龄呈正相关。其中,老年组的术前住院时间相对更长(P=0.021),青年组的总住院时间相对更长(P=0.028)。此外,不同年龄组的结直肠癌患者在管理流程上的差异存在统计学意义(χ2=32.824,P<0.05),但就每个流程管理分类而言,不同年龄分组的患者选择与总体选择倾向性相同,“常规”管理占最大的比例,“快速”管理占比次之。结论结直肠癌患者的年龄分组对住院时间有一定的影响,老年患者的术前住院时间相对更长,而对总住院时间的影响还有待讨论。不同年龄段之间临床管理流程的构成存在差异,老年患者选择快速流程管理的比例相对更高。Objective To analyze the influence of the age of colorectal cancer patients served by West China Hospital as a regional center on hospitalization process in the current version of Database from Colorectal Cancer(DACCA).Methods The DACCA version was updated on January 5,2022.All data items analyzed included age,date of admission,date of operation,date of discharge,pre-operation time,post-operation time,total hospital stay and management process.Data were assigned to three groups according to age with≤45,46–64 and≥65 years old.Results After scanning,8013 data rows were obtained,from 2005 to 2022.The patients’ages ranged from 14 to 104 years old,and were(58.01±13.52)years old in average.The results showed that the relationship between age and postoperative time was not statistically related(P>0.05).However,the pre-operative time(P=0.001)and total hospital stay time(P=0.005)were positively correlated with the age of colorectal cancer patients.The pre-operation time was longer in the older-aged group(P=0.021).Youth group had longer total hospital stay than other groups(P=0.028).Additionally,there was significant difference in the management process of colorectal cancer patients of different age groups(χ2=32.824,P<0.05),but in terms of each process management classification,patients in different age groups had the same choice tendency as the overall choice,with“routine”management accounting for the largest proportion.“ERAS(enhanced recovery after surgery)”management was in the second place.Conclusions This study showed that the age group of patients with colorectal cancer has a certain influence on the length of hospital stay.Older patients have longer preoperation time,but the effect of age on the total length of hospital stay still remains to be discussed.The composition of clinical management process varies among different age groups,and the elderly patients received the highest proportion of“ERAS”management process.

关 键 词：结直肠癌 年龄 住院管理 华西肠癌数据库 

分 类 号：R735.34[医药卫生—肿瘤] R197.3[医药卫生—临床医学]