The impact of comorbidity and stage on ovarian cancer mortality: A nationwide Danish cohort study

Abstract

Background: The incidence of ovarian cancer increases sharply with age, and many elderly patients have coexisting diseases. If patients with comorbidities are diagnosed with advanced stages, this would explain the poor survival observed among ovarian cancer patients with severe comorbidity. Our aims were to examine the prevalence of comorbidity according to stage of cancer at diagnosis, to estimate the impact of comorbidity on survival, and to examine whether the impact of comorbidity on survival varies by stage.

An Analysis of a Cohort of Surgical-Related Intraabdominal Sepsis With PIRO

“…Our results are in agreement with studies that have identified greater risk of mortality in septic patients with higher number of comorbidities using a large US National Hospital Discharge Survey database from 1979 through 2003 [86]. Comorbidities as a predictor of mortality and hospital LOS had been reported in patients with cancer [87], patients with cirrhosis [88], critically ill patients in ICU [89], and general hospital population [90]. This association showed a possible synergy between the effects of sepsis and comorbidities, which suggest that treatment of comorbidities should be considered an integral part of clinical care for patients with sepsis.…”

Do stage of disease, comorbidity or access to treatment explain socioeconomic differences in survival after ovarian cancer? – A cohort study among Danish women diagnosed 2005–2010

“…Treatment opportunities have changed since the CCI weights were constructed [22], and milder or more severe forms of some conditions might be assigned the same CCI weight. However data show a clear difference in survival between CCI scores 0 and 3, although the impact of comorbidity on mortality was smaller than what was shown from other Danish studies [6,7]. To further analyze whether differential health status could explain the survival differences, we adjusted for ASA score and secondly for BMI [12,40].…”

“…Cancer patients with lower socioeconomic positions also tend to have more comorbid conditions at time of diagnosis [5], a prognostic factor for allcause mortality among these patients [6,7]. Comorbidity may affect the timing of diagnosis by delaying health care-seeking or, conversely, increasing the frequency of health care contacts [7], which may also influence the choice or aggressiveness of cancer treatment [8,9]. Other studies suggest that patients in lower socioeconomic positions receive suboptimal treatment [3,10,11].…”

“…The symptoms of ovarian cancer are often weak or non-specific, and about 70% of cases are diagnosed in advanced stages [4]. Cancer patients with lower socioeconomic positions also tend to have more comorbid conditions at time of diagnosis [5], a prognostic factor for allcause mortality among these patients [6,7]. Comorbidity may affect the timing of diagnosis by delaying health care-seeking or, conversely, increasing the frequency of health care contacts [7], which may also influence the choice or aggressiveness of cancer treatment [8,9].…”

Frequency and correlates of antipsychotic polypharmacy among patients with schizophrenia in Denmark: A nation-wide pharmacoepidemiological study

“…Information on physical morbidity was collected from diagnoses recorded in the Danish National Patient Registry, coded by the Danish version of the International Classification of Diseases (ICD-8 and ICD-10). Physical morbidity was classified according to the Charlson Co-morbidity Index (CCI) (Charlson et al, 1987) as used in a previous study (Tetsche et al, 2008). The CCI (ranging from 0 to 38 points) was used in the regression model as a continuous variable, i.e., the displayed OR indicates the change in estimates by a one-point increase in CCI score.…”