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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.

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author
; ; ; ; ; ; ; and
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
external identifiers
  • scopus:85030653668
  • wos:000412465700105
  • pmid:29113389
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
2024-04-14 21:08:51
@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}},
  keywords     = {{Esophageal cancer; Gastric cancer; Prognosis; Psychiatric morbidity; Surgery}},
  language     = {{eng}},
  number       = {{46}},
  pages        = {{81305--81314}},
  publisher    = {{Impact Journals}},
  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}},
  doi          = {{10.18632/oncotarget.18347}},
  volume       = {{8}},
  year         = {{2017}},
}