Razlike u ishodima operisanih od kolorektalnog karcinoma u Srbiji: bolnice u organizovanom skriningu kolorektalnog karcinoma i ostale bolnice
Sažetak
Uvod i cilj: Cilj rada je bio da se analizira smrtnost pacijenata operisanih od kolorektalnog karcinoma u bolnicama u organizovanom skriningu kolorektalnog karcinoma i bolnicama van skrininga u Srbiji.
Metod: Korišćena je baza pacijenata operisanih od kolorektalnog karcinoma posle uvođenja Programa organizovanog skrininga iz svih bolnica u Srbiji, u periodu 2014- 2015. godine. Operisani pacijenti su analizirani u odnosu na ciljnu grupu iz organizovanog skrininga 50-74 godine, i poređeni su sa operisanim pacijentima iste starosne grupe u bolnicama van skrininga. Za značajnost razlike u posmatranim varijablama, kao i za utvrđuvanje prediktora smrtnog ishoda posle operacije kolorektalnog karcinoma korišćena je univarijantna logistička regresija.
Rezultati: Od 3631 pacijenta operisanog od kolorektalnog karcinoma, najviše je hospitalizovano zbog karcinoma rektuma 2112 (58,2%), a manje zbog karcinoma kolona 1063 ( 29,2%). Postoperativno preživljavanje je bilo značajno bolje u ciljnoj u organizovanom skriningu (p=0,000; OR=0,46; 95% CI 0,33-0,62). Postojala je visoko statistički značajna razlika pacijenata operisanih od kolorektalnog karcinoma lokalizovanog u levom kolonu u odnosu na operisane sa lokalizacijom u desnom kolonu (p<0,001). Smrtni ishod posle operacije kolorektalnog karcinoma (4,7%) praćen je povišenim komorbiditetom od kardiovaskularnih bolesti (24%).
Zaključak: Pacijenti koji su uključeni u organizovani skrining kolorektalnog karcinoma imaju manji rizik za umiranje posle operacije kolorektalnog karcinoma od pacijenata koji nisu uključeni u program. Ovo nalaže dalji rad na organizovaniom skriningu kolorektalnog karcinoma u cilju smanjivanja operativnog i opšteg mortaliteta.
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