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1003 来自SCI天天读 00:00 02:43 SCI 3 October 2019 Association of Early Palliative Care Use With Survival and Place of Death Among Patients With Advanced Lung Cancer Receiving Care in the Veterans Health Administration 退伍军人健康管理局的护理
IMPORTANCE 重要性 Palliative care is a patient-centered approach associated with improvements in quality of life; however, results regarding its association with a survival benefit have been mixed, which may be a factor in its underuse. 姑息治疗是一种以患者为中心的方法，可改善生活质量。然而，关于其与生存利益相关的结果好坏参半，这可能是其使用不足的一个因素。 OBJECTIVE 目的 To assess whether early palliative care is associated with a survival benefit among patients with advanced lung cancer. 评估早期姑息治疗是否与晚期肺癌患者的生存获益相关。 DESIGN, SETTING, AND PARTICIPANTS 设计，设置和参与者 This retrospective population-based cohort study was conducted among patients with lung cancer who were diagnosed with cancer between January 1, 2007, and December 31, 2013, with follow-up until January 23, 2017. Participants comprised 23 154 patients with advanced lung cancer (stage IIIB and stage IV) who received care in the Veterans Affairs health care system. Data were analyzed from February 15, 2019, to April 28, 2019. 这项基于人群的回顾性队列研究是在2007年1月1日至2013年12月31日期间被诊断患有癌症的肺癌患者中进行的，随访至2017年1月23日。参加者包括23 154名在退伍军人事务医疗体系中接受过治疗的晚期肺癌患者（IIIB期和IV期）。分析了从2019年2月15日到2019年4月28日的数据。 EXPOSURE 暴露 Palliative care defined as a specialist-delivered palliative care encounter received after lung cancer diagnosis 姑息治疗定义为诊断为肺癌后接受专家提供的姑息治疗 MAIN OUTCOMES AND MEASURES 主要成果和措施 The primary outcome was survival. The association between palliative care and place of death was also examined. Propensity score and time-varying covariate methods were used to calculate Cox proportional hazards and to perform regression modeling. 主要结果是生存。还研究了姑息治疗与死亡地点之间的关联。倾向得分和时变协变量方法用于计算Cox比例风险并进行回归建模。 RESULTS 结果 Of the 23 154 patients enrolled in the study, 57% received palliative care. The mean (SD) age of participants was 68 years, and 98% of participants were men.An examination of the timing of palliative care receipt relative to cancer diagnosis found that palliative care received 0 to 30 days after diagnosis was associated with decreases in survival, palliative care received 31 to 365 days after diagnosis was associated with increases in survival, and palliative care received more than 365 days after diagnosis was associated with no difference in survival compared with nonreceipt of palliative care.Receipt of palliative care was also associated with a reduced risk of death in an acute care setting compared with nonreceipt of palliative care. 在这项研究的23154名患者中，有57％得到了姑息治疗。参与者的平均（SD）年龄为68岁，其中98％为男性。对与癌症诊断有关的姑息治疗接受时间的检查发现，诊断后0至30天接受姑息治疗与生存率降低相关，诊断后31至365天接受姑息治疗与生存率增加相关，而姑息治疗 与未接受姑息治疗相比，确诊后超过365天接受治疗与生存率无差异。与未接受姑息治疗相比，接受姑息治疗还可以降低急性护理中的死亡风险。 CONCLUSIONS AND RELEVANCE 结论与关联 The results suggest that palliative care was associated with a survival benefit among patients with advanced lung cancer. Palliative care should be considered a complementary approach to disease-modifying therapy in patients with advanced lung cancer. 结果表明，姑息治疗与晚期肺癌患者的生存获益相关。姑息治疗应被视为晚期肺癌患者疾病缓解疗法的补充方法。 喜欢SCI天天读的理由 陪您一起学习SCI医学论文 每天5分钟，让自己的英语牛逼起来 特殊福利让您惊喜连连 |
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