结直肠癌患者文化程度与住院管理流程及住院时间的关系:基于DACCA的真实世界数据研究

Association between cultural level of patients with colorectal cancer and hospitalization management process and length of hospitalization:a real-world study based on DACCA

目的分析在目前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中,四川大学华西医院作为区域性中心所服务的结直肠患者人群的文化程度与住院管理流程及住院时间的关系。方法根据制定的筛选条件,从2022年6月29日更新版DACCA中收集符合条件的结直肠癌患者,其中分析的数据项目包括:性别、年龄、BMI、血型、婚姻、入院前等候时间、术前住院时间、术后住院时间、总住院时间及管理流程,并按文化程度分为文盲组、初等教育组、中等教育组和高等教育组,比较4组患者的住院时间和管理流程。结果共筛选出符合条件的数据4765条,其中中等教育最多(2792条,58.6%),之后为初等教育(1337条,28.1%)和高等教育(417条,8.7%),文盲最少(219条,4.6%)。在管理流程的分类中,“常规”管理流程占大多数(4219条,88.5%),“加强”管理流程次之(274条,5.8%),“个体”第三(231条,4.8%),“快速”最少(41条,0.9%)。不同文化程度患者的入院前等候时间、术前住院时间和术后住院时间比较差异均无统计学意义(P=0.371,P=0.095,P=0.352),但总住院时间有统计学意义(P=0.021),文盲患者的总住院时间长于中等教育患者(P=0.041)。不同文化程度组患者的住院管理流程比较差异无统计学意义(χ^(2)=15.2,P=0.085)。结论通过DACCA数据分析发现,文化程度为文盲和中等教育患者的总住院时间的差异有统计学意义,但是不同文化程度患者住院管理流程的选择相似,需要进一步分析其原因。

Objective To analyze the association between the cultural level and hospitalization management process and length of hospitalization of the colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of the Database from Colorectal Cancer(DACCA).Method According to the established screening criteria,eligible colorectal cancer patients were collected from the updated version of DACCA on June 29,2022.The analyzed data items included gender,age,BMI,blood type,marriage,waiting time before admission,preoperative hospitalization time,postoperative hospitalization time,total hospitalization time,and management process,and patients were divided into illiterate group,primary education group,medium education group,and higher education group according to their educational level,then compared the hospitalization management process and length of hospitalization of each group.Results A total of 4765 eligible data were screened,with secondary education being the most prevalent(2792,58.6%),followed by primary(1337,28.1%)and higher education(417,8.7%),and illiteracy being the least prevalent(219,4.6%).In the classification of management processes,“regular”account for the majority(4219,88.5%),followed by“enhanced”(274,5.8%),“individual”was third(231,4.8%),and“rapid”was the least(41,0.9%).There was no statistically significant difference in the comparison of waiting time before admission,preoperative hospitalisation time and postoperative hospitalisation time among patients with different literacy levels(P=0.371,P=0.095,P=0.352),but there was a statistically significant difference in total hospitalisation time(P=0.021),with a significant difference in total hospitalisation length between illiterate patients and patients with medium education(P=0.041).There was no statistically significant difference in the comparison of inpatient management processes of patients in different literacy groups(χ^(2)=15.2,P=0.085).Conclusions Analysis of the DACCA data revealed a statistically significant difference in total hospitalisation time between patients with illiteracy and those with medium education.However,the choice of hospitalisation management process was similar for patients with different literacy levels,which needs to be further analysed for the reasons.