Advanced

Psychiatric morbidity and its impact on surgical outcomes for esophageal and gastric cancer patients : A nationwide cohort study

Song, Huan; Zhu, Jianwei; Lu, Donghao; Fang, Fang; Ye, Weimin; Lundell, Lars; Johansson, Jan LU ; Lindblad, Mats and Nilsson, Magnus (2017) In Oncotarget 8(46). p.81305-81314
Abstract

Background: Due to the lack of detailed clinical information, existed evidence regarding a link between psychiatric factors and adverse cancer prognosis was inclusive. Results: We identified 1,340 patients (48.8%) with perioperative psychiatric morbidity. Preoperative psychiatric morbidity was significantly associated with both general and surgical complications within 30 days (RR = 1.3, 95% confidence interval [CI] 1.1-1.5), and the risk of death within 90 days (RR = 1.6; 95% CI 1.1-2.2) after surgery. The hazards for mortality beyond 90 days was approximately 2-fold increased among patients with perioperative psychiatric morbidity (HR = 2.0, 95% CI 1.7-2.3 for overall mortality). Materials and Methods: Based on the Swedish National... (More)

Background: Due to the lack of detailed clinical information, existed evidence regarding a link between psychiatric factors and adverse cancer prognosis was inclusive. Results: We identified 1,340 patients (48.8%) with perioperative psychiatric morbidity. Preoperative psychiatric morbidity was significantly associated with both general and surgical complications within 30 days (RR = 1.3, 95% confidence interval [CI] 1.1-1.5), and the risk of death within 90 days (RR = 1.6; 95% CI 1.1-2.2) after surgery. The hazards for mortality beyond 90 days was approximately 2-fold increased among patients with perioperative psychiatric morbidity (HR = 2.0, 95% CI 1.7-2.3 for overall mortality). Materials and Methods: Based on the Swedish National Registry for Esophageal and Gastric cancer (NREV), we constructed a nationwide prospective cohort containing 2,745 surgically treated patients in 2006-2012. Perioperative psychiatric morbidity was defined as a clinical diagnosis of psychiatric disorder, from two years before to two years after surgery. Using propensity scores, we applied inverse probability of treatment weights (IPTW)-weighted Poisson regression model to evaluate relative risk (RR) of short-term surgical outcomes in relation to perioperative psychiatric morbidity. Further, IPTW-weighted Cox proportional hazards model was used to estimate hazard ratios (HRs) for mortality that occurred after 90 days of surgery. Conclusions: Perioperative psychiatric morbidity could worsen both short-term and long-term surgical outcomes among patients with gastric or esophageal cancer.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Esophageal cancer, Gastric cancer, Prognosis, Psychiatric morbidity, Surgery
in
Oncotarget
volume
8
issue
46
pages
10 pages
publisher
Impact Journals, LLC
external identifiers
  • scopus:85030653668
ISSN
1949-2553
DOI
10.18632/oncotarget.18347
language
English
LU publication?
yes
id
12c24687-74a5-4e4a-b4a4-c7b4e5990a54
date added to LUP
2017-11-07 14:56:11
date last changed
2018-01-07 12:25:10
@article{12c24687-74a5-4e4a-b4a4-c7b4e5990a54,
  abstract     = {<p>Background: Due to the lack of detailed clinical information, existed evidence regarding a link between psychiatric factors and adverse cancer prognosis was inclusive. Results: We identified 1,340 patients (48.8%) with perioperative psychiatric morbidity. Preoperative psychiatric morbidity was significantly associated with both general and surgical complications within 30 days (RR = 1.3, 95% confidence interval [CI] 1.1-1.5), and the risk of death within 90 days (RR = 1.6; 95% CI 1.1-2.2) after surgery. The hazards for mortality beyond 90 days was approximately 2-fold increased among patients with perioperative psychiatric morbidity (HR = 2.0, 95% CI 1.7-2.3 for overall mortality). Materials and Methods: Based on the Swedish National Registry for Esophageal and Gastric cancer (NREV), we constructed a nationwide prospective cohort containing 2,745 surgically treated patients in 2006-2012. Perioperative psychiatric morbidity was defined as a clinical diagnosis of psychiatric disorder, from two years before to two years after surgery. Using propensity scores, we applied inverse probability of treatment weights (IPTW)-weighted Poisson regression model to evaluate relative risk (RR) of short-term surgical outcomes in relation to perioperative psychiatric morbidity. Further, IPTW-weighted Cox proportional hazards model was used to estimate hazard ratios (HRs) for mortality that occurred after 90 days of surgery. Conclusions: Perioperative psychiatric morbidity could worsen both short-term and long-term surgical outcomes among patients with gastric or esophageal cancer.</p>},
  author       = {Song, Huan and Zhu, Jianwei and Lu, Donghao and Fang, Fang and Ye, Weimin and Lundell, Lars and Johansson, Jan and Lindblad, Mats and Nilsson, Magnus},
  issn         = {1949-2553},
  keyword      = {Esophageal cancer,Gastric cancer,Prognosis,Psychiatric morbidity,Surgery},
  language     = {eng},
  number       = {46},
  pages        = {81305--81314},
  publisher    = {Impact Journals, LLC},
  series       = {Oncotarget},
  title        = {Psychiatric morbidity and its impact on surgical outcomes for esophageal and gastric cancer patients : A nationwide cohort study},
  url          = {http://dx.doi.org/10.18632/oncotarget.18347},
  volume       = {8},
  year         = {2017},
}