01.12.2017 | Research article | Ausgabe 1/2017 Open Access

Waiting time for cancer treatment and mental health among patients with newly diagnosed esophageal or gastric cancer: a nationwide cohort study
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Electronic supplementary material
Background
Methods
Database and study design
Waiting time for cancer treatment
Ascertainment of mental disorders
Statistical analyses
Patients without previous mental disorders
Patient with previous mental disorders
Sensitivity analysis
Results
Characteristics
|
All
|
Waiting time groups
|
||||
---|---|---|---|---|---|---|
1–8 days
|
9–17 days
|
18–29 days
|
30–60 days
|
>60 days
|
||
Number of patients
|
7080
|
1733
|
1542
|
1556
|
1601
|
648
|
Demographic factors
|
||||||
Age, mean ± SD, years
|
71.4 ± 11.9
|
73.7 ± 12.5
|
70.4 ± 12.2
|
70.4 ± 11.6
|
71.1 ± 11.1
|
70.3 ± 11.1
|
Gender (% male)
|
65.7
|
63.1
|
67.1
|
66.3
|
65.5
|
69.0
|
Material status, n (%)
|
||||||
Single
|
914 (12.9)
|
235 (13.6)
|
227 (14.7)
|
180 (11.6)
|
189 (11.8)
|
83 (12.8)
|
Married
|
3626 (51.2)
|
797 (46.0)
|
806 (52.3)
|
843 (54.2)
|
842 (52.6)
|
338 (52.2)
|
Divorce
|
1158 (16.4)
|
284 (16.4)
|
236 (15.3)
|
242 (15.6)
|
284 (17.7)
|
112 (17.3)
|
Widow/widower
|
1368 (19.3)
|
411 (23.7)
|
271 (17.6)
|
288 (18.5)
|
283 (17.7)
|
115 (17.8)
|
Missing
|
14 (0.2)
|
6 (0.3)
|
2 (0.1)
|
3 (0.2)
|
3 (0.2)
|
0 (0.0)
|
Education level, n (%)
|
||||||
< =9 years
|
3070 (43.4)
|
778 (44.9)
|
655 (42.5)
|
643 (41.3)
|
700 (43.7)
|
294 (45.4)
|
10–12 years
|
2561 (36.2)
|
586 (33.8)
|
545 (35.3)
|
578 (37.2)
|
600 (37.5)
|
252 (38.9)
|
> =12 years
|
1038 (14.7)
|
227 (13.1)
|
239 (15.5)
|
255 (16.4)
|
235 (14.7)
|
82 (12.7)
|
Missing
|
411 (5.8)
|
142 (8.2)
|
103 (6.7)
|
80 (5.1)
|
66 (4.1)
|
20 (3.1)
|
Disease-related factors
|
||||||
Time of follow-up (months, until death, emigration or the end of study)
|
||||||
Mean ± SD
|
15.6 ± 18.0
|
10.4 ± 16.1
|
13.0 ± 15.8
|
16.3 ± 17.7
|
18.5 ± 18.0
|
26.6 ± 21.5
|
Hospital Volume
|
||||||
Low (<20 cases/year)
|
3310 (46.8)
|
975 (56.3)
|
749 (48.6)
|
664 (42.7)
|
659 (41.2)
|
263 (40.5)
|
Median (20–40 cases/year)
|
1868 (26.4)
|
442 (25.5)
|
456 (29.5)
|
420 (27.0)
|
387 (24.1)
|
163 (25.2)
|
High (>40 cases/year)
|
1899 (26.8)
|
314 (18.1)
|
337 (21.9)
|
471 (30.3)
|
555 (34.7)
|
222 (34.3)
|
Missing
|
2 (0.0)
|
0 (0.0)
|
1 (0.0)
|
0 (0.0)
|
0 (0.0)
|
3 (0.0)
|
ASA physical status, n (%)
|
||||||
I-II
|
4319 (61.0)
|
902 (52.1)
|
970 (62.9)
|
1023 (65.8)
|
1030 (64.3)
|
394 (60.7)
|
III-IV
|
2588 (36.6)
|
791 (45.6)
|
529 (34.3)
|
494 (31.8)
|
539 (33.7)
|
235 (36.3)
|
Missing
|
173 (2.4)
|
40 (2.3)
|
43 (2.8)
|
39 (2.4)
|
32 (2.0)
|
19 (2.9)
|
Cancer type, n (%)
|
||||||
Gastric cancer
|
3562 (50.3)
|
1004 (57.9)
|
788 (51.1)
|
737 (47.4)
|
715 (44.7)
|
318 (49.1)
|
Esophageal cancer
|
3518 (49.7)
|
729 (42.1)
|
754 (48.9)
|
819 (52.6)
|
886 (55.3)
|
330 (50.9)
|
Cancer stage, n (%)
|
||||||
Stage 0
|
191 (2.70)
|
24 (1.38)
|
24 (1.56)
|
29 (1.86)
|
52 (3.25)
|
62 (9.57)
|
Stage I
|
905 (12.8)
|
131 (7.56)
|
157 (10.2)
|
226 (14.5)
|
260 (16.2)
|
131 (20.2)
|
Stage II
|
924 (13.1)
|
155 (8.94)
|
200 (13.0)
|
252 (16.2)
|
236 (14.7)
|
81 (12.5)
|
Stage III
|
2824 (39.9)
|
688 (39.7)
|
601 (39.0)
|
615 (39.5)
|
671 (41.9)
|
249 (38.4)
|
Stage IV
|
2188 (30.9)
|
726 (41.9)
|
557 (36.1)
|
423 (27.2)
|
369 (23.1)
|
113 (17.4)
|
Missing
|
48 (0.7)
|
9 (0.5)
|
3 (0.2)
|
11 (0.7)
|
13 (0.8)
|
12 (1.9)
|
Admission type, n (%)
|
||||||
GP referral
|
5406 (76.4)
|
1071 (61.8)
|
1128 (73.2)
|
1303 (83.7)
|
1367 (85.4)
|
537 (82.9)
|
Emergency intake
|
1517 (21.4)
|
627 (36.2)
|
367 (23.8)
|
225 (14.5)
|
201 (12.6)
|
97 (15.0)
|
Missing
|
157 (2.2)
|
35 (2.0)
|
47 (3.0)
|
28 (1.8)
|
33 (2.0)
|
14 (2.1)
|
Treatment decided through multidisciplinary conference, n (%)
|
||||||
Yes
|
4080 (57.6)
|
668 (38.6)
|
929 (60.3)
|
990 (63.6)
|
1074 (67.1)
|
419 (64.7)
|
No
|
2953 (41.7)
|
1053 (60.8)
|
599 (38.9)
|
556 (35.7)
|
521 (32.5)
|
224 (34.6)
|
Missing
|
47 (0.7)
|
12 (0.6)
|
14 (0.8)
|
10 (0.7)
|
6 (0.4)
|
5 (0.7)
|
Planned treatment type, n (%)
|
||||||
Curative
|
3038 (42.9)
|
484 (27.9)
|
607 (39.4)
|
783 (50.3)
|
824 (51.5)
|
340 (52.5)
|
Palliative
|
2631 (37.2)
|
714 (41.2)
|
663 (43.0)
|
547 (35.2)
|
548 (34.2)
|
159 (24.5)
|
Supportive
|
1400 (19.8)
|
531 (30.6)
|
271 (17.6)
|
226 (14.5)
|
227 (14.2)
|
145 (22.4)
|
Missing
|
11 (0.1)
|
4 (0.3)
|
1 (0.0)
|
0 (0.0)
|
2 (0.1)
|
4 (0.6)
|
Patients without previous mental disorders
Outcomes
|
Number of cases
|
1–8 days
|
9–17 days
|
18–29 days
|
30–60 days
|
---|---|---|---|---|---|
All mental disorders
|
1268
|
1.07 (0.91–1.25)
|
1.00 (reference)
|
0.86 (0.73–1.01)
|
0.79 (0.67–0.93)
|
Mental disorders identified by in-/out-patient diagnosis
|
129
|
0.79 (0.47–1.34)
|
1.00 (reference)
|
0.85 (0.54–1.33)
|
0.56 (0.34–0.93)
|
Mental disorders identified through drug prescription
|
1227
|
1.09 (0.93–1.29)
|
1.00 (reference)
|
0.88 (0.75–1.04)
|
0.82 (0.69–0.97)
|
Depression (ICD10:F32,F33 or/and ATC N06A)
|
317
|
0.96 (0.69–1.34)
|
1.00 (reference)
|
0.91 (0.67–1.23)
|
0.66 (0.48–0.92)
|
Anxiety (ICD10:F40,F41 or/and ATC N05B)
|
799
|
1.21 (0.99–1.48)
|
1.00 (reference)
|
0.87 (0.71–1.06)
|
0.84 (0.68–1.03)
|
Patients with previous mental disorders
Waiting time group
|
Hazard Ratios (HRs) and 95% Confidence Intervals (CIs)
a
|
|||||
---|---|---|---|---|---|---|
All psychiatric cares
|
Hopsital visits
|
Medication prescriptions
|
||||
≤1 year
|
>1 year
|
≤1 year
|
>1 year
|
≤1 year
|
>1 year
|
|
1–8 days
|
0.90 (0.74–1.10)
|
0.68 (0.44–1.07)
|
0.80 (0.49–1.31)
|
0.36 (0.14–0.91)
|
0.90 (0.74–1.10)
|
0.72 (0.46–1.13)
|
9–17 days
|
1.00 (reference)
|
1.00 (reference)
|
1.00 (reference)
|
1.00 (reference)
|
1.00 (reference)
|
1.00 (reference)
|
18–29 days
|
1.04 (0.86–1.26)
|
0.84 (0.51–1.24)
|
1.49 (0.98–2.25)
|
0.80 (0.38–1.72)
|
1.01 (0.83–1.23)
|
0.79 (0.51–1.22)
|
30–60 days
|
1.09 (0.91–1.32)
|
0.70 (0.47–1.02)
|
2.01 (1.24–3.24)
|
0.51 (0.24–1.07)
|
1.03 (0.85–1.24)
|
0.71 (0.48–1.04)
|