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Psychiatric morbidity and survival after surgery for esophageal cancer: a population-based cohort study.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2015 Feb 10; Vol. 33 (5), pp. 448-54. Date of Electronic Publication: 2014 Dec 29. - Publication Year :
- 2015
-
Abstract
- Purpose: To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer.<br />Patients and Methods: A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival.<br />Results: In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs).<br />Conclusion: These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.<br /> (© 2014 by American Society of Clinical Oncology.)
- Subjects :
- Adenocarcinoma psychology
Adenocarcinoma surgery
Adult
Aged
Carcinoma, Squamous Cell psychology
Carcinoma, Squamous Cell surgery
Cohort Studies
Esophageal Neoplasms mortality
Female
Humans
Incidence
Inpatients statistics & numerical data
Logistic Models
Male
Mental Disorders therapy
Middle Aged
Morbidity
Odds Ratio
Outpatients statistics & numerical data
Prognosis
Proportional Hazards Models
Registries
Risk Assessment
Risk Factors
Stress, Psychological psychology
Sweden epidemiology
Esophageal Neoplasms psychology
Esophageal Neoplasms surgery
Mental Disorders epidemiology
Mental Disorders etiology
Stress, Psychological epidemiology
Stress, Psychological etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1527-7755
- Volume :
- 33
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 25547500
- Full Text :
- https://doi.org/10.1200/JCO.2014.57.1893