重庆某三甲医院恶性肿瘤住院患者伴心血管疾病的流行病学特征分析

Epidemiological Features of Inpatients with Malignant Tumors and Cardiovascular Diseases in a Level A Tertiary Hospital in Chongqing

目的:分析2014~2018年重庆某三甲医院恶性肿瘤住院患者伴心血管疾病的构成情况,探讨恶性肿瘤与心血管疾病的关系,为恶性肿瘤合并心血管疾病的防治措施的制定提供科学依据。方法:回顾性分析2014~2018年间重庆市某三甲医院收治的新发恶性肿瘤患者,使用医院信息系统提取患者的年龄、性别、治疗方式,TNM分期等信息,采用国际疾病分类ICD-10编码,对出院诊断进行归类,同时利用身份证号进行剔重,统计分析住院治疗的新发恶性肿瘤患者合并心血管疾病的情况。结果:5年共收治11 620例新发恶性肿瘤患者,平均年龄(61. 17±12. 52)岁。其中合并心血管疾病诊断的有4 897人,占42. 14%,平均年龄(65. 82±10. 85)岁;不同年份收治的新发恶性肿瘤患者中合并心血管疾病的比例差异有统计学意义(χ^2=1 436. 691,P <0. 001),其中2018年共有1 322例患者合并心血管疾病,占28. 59%;不同年龄段患者合并心血管的比例差异有统计学意义(χ^2=1 118. 635,P <0. 001),其中大于等于66岁患者合并心血管疾病的人数最多,共计2 571例(占58. 13%);不同治疗方式的患者合并心血管疾病的比例差异有统计学意义(χ^2=237. 519,P <0. 001),其中单纯放、化疗的患者合并心血管疾病的比例相对较高;不同TNM分期的患者合并心血管疾病的比例差异有统计学意义(χ2=94. 271,P <0. 001),其中分期越晚的患者合并心血管疾病的比例越大;不同性别、民族、婚姻状况的患者合并心血管疾病的比例差异无统计学意义。结论:未来肿瘤合并心血管疾病的人群基数会越来越大,更多的肿瘤患者需要在治疗肿瘤的同时兼顾心血管疾病的治疗,尽量避免抗肿瘤治疗引发的心血管毒性。

Objective:To analyze the epidemiological characteristics of hospitalized patients with malignant tumors and cardiovascular diseases in a level A tertiary hospital in Chongqing between 2014 and 2018,and explore the relationship between malignant tumors and cardiovascular diseases,so as to provide scientific basis for the development of prevention and treatment measures for malignant tumors combined with cardiovascular diseases.Methods:Patients with new malignant tumors admitted to a level A tertiary hospital in Chongqing from 2014 to 2018 were retrospectively analyzed.Hospital information system was used to retrieve patients’age,gender,treatment mode,TNM stage and other information.The 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10)was used to classify the discharge diagnosis.At the same time,identification numbers were used to remove duplicates.Finally,incidence of cardiovascular diseases with malignant tumors was analyzed.Results:A total of 11,620 new cancer cases were admitted,with an average age of 61.17±12.52 years.Among them,4,897 patients were diagnosed with cardiovascular diseases,accounting for 42.14%,with an average age of 65.82±10.85 years.Among newly diagnosed cancer patients treated in different years,the proportion of cardiovascular diseases was significantly different(P<0.001).A total of 1,322 patients(28.59%)had cardiovascular diseases in 2018.There was statistically significant difference in the proportion of patients with cardiovascular diseases among different age groups(P<0.001).The highest incidence of cardiovascular diseases occurred in those aged 66 or older(2,571,58.13%).There was statistically significant difference in the proportion of cardiovascular diseases among patients treated by different methods(P<0.001).The proportion of patients complicated with cardiovascular diseases was relatively high in patients treated with radiotherapy or chemotherapy alone.The proportion of cardiovascular diseases was significantly different among patients with different TNM stages(P<0.001).The later the stage was,the greater the proportion of patients with cardiovascular diseases was.There was no statistically significant difference in the proportion of cardiovascular diseases among patients of different genders,ethnic groups and marital status.Conclusion:The population of tumors combined with cardiovascular diseases will be larger and larger in the future,and more tumor patients need to control both tumors and cardiovascular diseases to avoid cardiovascular toxicity caused by anti-tumor treatment.