Risk Factors for Bowel Obstruction and Effect of Survival on Newly Diagnosed Colorectal Cancer Patients: An Example of 2000'2009 Colorectal Cancer Cohorts in Taiwan

2.50
Hdl Handle:
http://hdl.handle.net/10755/601615
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Title:
Risk Factors for Bowel Obstruction and Effect of Survival on Newly Diagnosed Colorectal Cancer Patients: An Example of 2000'2009 Colorectal Cancer Cohorts in Taiwan
Author(s):
Hsieh, Pi-Ching; Su, Hui-Fang
Lead Author STTI Affiliation:
Non-member
Author Details:
Pi-Ching Hsieh, PhD, RN, hpc@ntunhs.edu.tw; Hui-Fang Su, PhD, RN
Abstract:
Session presented on Saturday, July 25, 2015: Purpose: Bowel obstruction (BO) is major complication after resection of colorectal cancer, and is associated with increased mortality. The purpose of this retrospective cohort study was to investigate the incidence and risk factors for developing a new BO in a population-based cohort of colorectal cancer patients who had undergone surgery, and also to determine the effect of BO on survival. Methods: A retrospective cohort study was conducted between 1997- 2010 using the National Health Insurance Research Database in Taiwan. The incidence of BO amongst 2000-2009 colorectal cancer cohorts and the associated risk factors were determined based on Poisson distribution. Propensity score matching was used to determine the effect of BO on 30-day and 1-year mortality through accelerated failure-time (AFT) model analysis.'' Results: 'Amongst 45,371 patients with newly diagnosed colorectal cancer between 2000 and 2009, the 1-year cumulative BO incidence was 7.93%, with a rate of 20.21 events/100 patient-years during the first month. Based on a multivariate model, significant predictors of developing BO within 1-year were age (adjusted incidence rate ratio[aIRR]=1.06 if ?75 years v?45; 95%CI [1.04-1.06]), gender (aIRR= 1.09 if men v female; 95%CI [1.08-1.09]), type of surgery (aIRR= 1.01 if rectal resection v colon resection; 95%CI [1-1.02]), history of perioperative transfusion (aIRR= 1.04 if yes v no; 95%CI [1.03-1.05]), and surgeon annual case volume (aIRR= 1.11 if high v extreme low; 95%CI [1.09-1.12]). Based on AFT model analysis, after controlling for other variables, patients with BO had a higher risk of 1-year mortality than those without BO (adjusted Rate Ratio= 2.72, 95%CI [1.05'1.72]) and had a constant hazard ratio over time. Conclusion: Approximately 7.93% of colorectal cancer patients developed BO within 1-year, with the highest incidence in the first month after surgery. Patients with BO have a higher risk of death. Early detection of risk factors of BO (such as older age, more co-morbidities, history of perioperative transfusion, anesthesia lasting ?4 hours) and appropriate prevention care should be provided by health professionals for decreasing the complications and improving the quality of cancer care. The results may be useful in the research context to facilitating the more efficient selection of high-risk patients as subjects on clinical trials of prevention of treatment.
Keywords:
colorectal cancer; Accelerated Failure Time Model; Bowel Obstuction
MeSH:
Colorectal Neoplasms; Intestinal Obstruction; Models, Statistical
Repository Posting Date:
17-Mar-2016
Date of Publication:
17-Mar-2016 ; 17-Mar-2016
Other Identifiers:
INRC15PST246
Conference Date:
2015
Conference Name:
26th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
San Juan, Puerto Rico
Description:
Research Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.titleRisk Factors for Bowel Obstruction and Effect of Survival on Newly Diagnosed Colorectal Cancer Patients: An Example of 2000'2009 Colorectal Cancer Cohorts in Taiwanen
dc.contributor.authorHsieh, Pi-Chingen
dc.contributor.authorSu, Hui-Fangen
dc.contributor.departmentNon-memberen
dc.author.detailsPi-Ching Hsieh, PhD, RN, hpc@ntunhs.edu.tw; Hui-Fang Su, PhD, RNen
dc.identifier.urihttp://hdl.handle.net/10755/601615-
dc.description.abstractSession presented on Saturday, July 25, 2015: Purpose: Bowel obstruction (BO) is major complication after resection of colorectal cancer, and is associated with increased mortality. The purpose of this retrospective cohort study was to investigate the incidence and risk factors for developing a new BO in a population-based cohort of colorectal cancer patients who had undergone surgery, and also to determine the effect of BO on survival. Methods: A retrospective cohort study was conducted between 1997- 2010 using the National Health Insurance Research Database in Taiwan. The incidence of BO amongst 2000-2009 colorectal cancer cohorts and the associated risk factors were determined based on Poisson distribution. Propensity score matching was used to determine the effect of BO on 30-day and 1-year mortality through accelerated failure-time (AFT) model analysis.'' Results: 'Amongst 45,371 patients with newly diagnosed colorectal cancer between 2000 and 2009, the 1-year cumulative BO incidence was 7.93%, with a rate of 20.21 events/100 patient-years during the first month. Based on a multivariate model, significant predictors of developing BO within 1-year were age (adjusted incidence rate ratio[aIRR]=1.06 if ?75 years v?45; 95%CI [1.04-1.06]), gender (aIRR= 1.09 if men v female; 95%CI [1.08-1.09]), type of surgery (aIRR= 1.01 if rectal resection v colon resection; 95%CI [1-1.02]), history of perioperative transfusion (aIRR= 1.04 if yes v no; 95%CI [1.03-1.05]), and surgeon annual case volume (aIRR= 1.11 if high v extreme low; 95%CI [1.09-1.12]). Based on AFT model analysis, after controlling for other variables, patients with BO had a higher risk of 1-year mortality than those without BO (adjusted Rate Ratio= 2.72, 95%CI [1.05'1.72]) and had a constant hazard ratio over time. Conclusion: Approximately 7.93% of colorectal cancer patients developed BO within 1-year, with the highest incidence in the first month after surgery. Patients with BO have a higher risk of death. Early detection of risk factors of BO (such as older age, more co-morbidities, history of perioperative transfusion, anesthesia lasting ?4 hours) and appropriate prevention care should be provided by health professionals for decreasing the complications and improving the quality of cancer care. The results may be useful in the research context to facilitating the more efficient selection of high-risk patients as subjects on clinical trials of prevention of treatment.en
dc.subjectcolorectal canceren
dc.subjectAccelerated Failure Time Modelen
dc.subjectBowel Obstuctionen
dc.subject.meshColorectal Neoplasmsen
dc.subject.meshIntestinal Obstructionen
dc.subject.meshModels, Statisticalen
dc.date.available2016-03-17T12:50:47Zen
dc.date.issued2016-03-17-
dc.date.issued2016-03-17en
dc.date.accessioned2016-03-17T12:50:47Zen
dc.conference.date2015en
dc.conference.name26th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationSan Juan, Puerto Ricoen
dc.descriptionResearch Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.en
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