Background: In the present study, we used the data from 14 hospitals to systematically evaluate the in-hospital mortality of patients with colorectal cancer as well as its influencing factors in Germany. Methods: This multicenter cross-sectional study included hospitalized patients with a main diagnosis of colorectal cancers in the period between January 2019 and July 2023. The outcome of the study was the prevalence of in-hospital mortality. To access the associations between demographic and clinical variables and in-hospital mortality, univariable and multivariable logistic regression analyses were conducted. Results: A total of 4146 colorectal cancer patients (mean age: 70.9 years; 45.3% female) were included. The in-hospital mortality rate was 8.7%. In a multivariable regression, seven variables were significantly associated with an increased in-hospital mortality, including ages of 71–80 years (OR: 2.08; 95% CI: 1.01–4.29), an age group >80 years (OR: 2.44; 95% CI: 1.18–5.05) as compared to an age group ≤ 50 years, patient clinical-complexity level (PCCL) 3 (OR: 3.01 95% CI: 1.81–4.99) and PCCL 4 (OR: 3.76; 95% CI: 2.22–6.38) as compared to PCCL 0, the presence of distant metastases (OR: 4.95; 95% CI: 3.79–6.48), renal failure (OR: 2.38; 95% CI: 1.80–3.14), peritonitis (OR: 1.87; 95% CI: 1.23–2.85), acute posthemorrhagic anemia (OR: 1.55; 95% CI: 1.11–2.15), and respiratory failure (OR: 3.28; 95% CI: 2.44–4.41). Conclusions: Our findings underscore the critical role of renal failure, peritonitis, acute posthemorrhagic anemia, and respiratory failure in influencing the mortality outcomes of colorectal cancer patients during hospitalization. The awareness and management of these risk factors may guide clinicians in formulating targeted interventions to improve patient outcomes and enhance the quality of care for individuals with colorectal cancer.
背景：本研究利用德国14家医院的数据，系统评估了结直肠癌患者的院内死亡率及其影响因素。方法：这项多中心横断面研究纳入了2019年1月至2023年7月期间主要诊断为结直肠癌的住院患者。研究结局指标为院内死亡率。通过单因素及多因素逻辑回归分析，探讨人口学特征和临床变量与院内死亡率之间的关联。结果：共纳入4146例结直肠癌患者（平均年龄70.9岁；女性占45.3%）。院内死亡率为8.7%。多因素回归分析显示，七个变量与院内死亡率升高显著相关：与≤50岁年龄组相比，71-80岁年龄组（OR：2.08；95% CI：1.01-4.29）和>80岁年龄组（OR：2.44；95% CI：1.18-5.05）；与患者临床复杂程度分级（PCCL）0级相比，PCCL 3级（OR：3.01；95% CI：1.81-4.99）和PCCL 4级（OR：3.76；95% CI：2.22-6.38）；远处转移（OR：4.95；95% CI：3.79-6.48）、肾功能衰竭（OR：2.38；95% CI：1.80-3.14）、腹膜炎（OR：1.87；95% CI：1.23-2.85）、急性失血后贫血（OR：1.55；95% CI：1.11-2.15）以及呼吸衰竭（OR：3.28；95% CI：2.44-4.41）。结论：本研究结果强调了肾功能衰竭、腹膜炎、急性失血后贫血和呼吸衰竭对结直肠癌患者住院期间死亡结局的重要影响。对这些风险因素的认知与管理可指导临床医生制定针对性干预措施，以改善患者预后并提升结直肠癌患者的医疗质量。
In-Hospital Mortality and Associated Factors among Colorectal Cancer Patients in Germany
肿瘤(癌症)患者之家