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Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls
BACKGROUND: Over the past years, the incidence of colorectal cancer has been increasing among young adults. A large percentage of these patients live at least 5 years after diagnosis, but it is unknown whether their rate of hospitalizations after this 5-year mark is comparable to the general populat...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472287/ https://www.ncbi.nlm.nih.gov/pubmed/23043307 http://dx.doi.org/10.1186/1472-6963-12-353 |
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author | Sutradhar, Rinku Forbes, Shawn Urbach, David R Paszat, Lawrence Rabeneck, Linda Baxter, Nancy N |
author_facet | Sutradhar, Rinku Forbes, Shawn Urbach, David R Paszat, Lawrence Rabeneck, Linda Baxter, Nancy N |
author_sort | Sutradhar, Rinku |
collection | PubMed |
description | BACKGROUND: Over the past years, the incidence of colorectal cancer has been increasing among young adults. A large percentage of these patients live at least 5 years after diagnosis, but it is unknown whether their rate of hospitalizations after this 5-year mark is comparable to the general population. METHODS: This is a population-based cohort consisting of 917 young adult survivors diagnosed with colorectal cancer in Ontario from 1992–1999 and 4585 matched cancer-free controls. A multistate model is presented to reflect and compare trends in the hospitalization process among survivors and their matched controls. RESULTS: Analyses under a multistate model indicate that the risk of a subsequent hospital admission increases as the number of prior hospitalizations increases. Among patients who are yet to experience a hospitalization, the rate of admission is 3.47 times higher for YAS than controls (95% CI (2.79, 4.31)). However, among patients that have experienced one and two hospitalizations, the relative rate of a subsequent admission decreases to 3.03 (95% CI (2.01, 4.56)) and 1.90 (95% CI (1.19, 3.03)), respectively. CONCLUSIONS: Young adult survivors of colorectal cancer have an increased risk of experiencing hospitalizations compared to cancer-free controls. However this relative risk decreases as the number of prior hospitalizations increases. The multistate approach is able to use information on the timing of hospitalizations and answer questions that standard Poisson and Negative Binomial models are unable to address. |
format | Online Article Text |
id | pubmed-3472287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34722872012-10-23 Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls Sutradhar, Rinku Forbes, Shawn Urbach, David R Paszat, Lawrence Rabeneck, Linda Baxter, Nancy N BMC Health Serv Res Research Article BACKGROUND: Over the past years, the incidence of colorectal cancer has been increasing among young adults. A large percentage of these patients live at least 5 years after diagnosis, but it is unknown whether their rate of hospitalizations after this 5-year mark is comparable to the general population. METHODS: This is a population-based cohort consisting of 917 young adult survivors diagnosed with colorectal cancer in Ontario from 1992–1999 and 4585 matched cancer-free controls. A multistate model is presented to reflect and compare trends in the hospitalization process among survivors and their matched controls. RESULTS: Analyses under a multistate model indicate that the risk of a subsequent hospital admission increases as the number of prior hospitalizations increases. Among patients who are yet to experience a hospitalization, the rate of admission is 3.47 times higher for YAS than controls (95% CI (2.79, 4.31)). However, among patients that have experienced one and two hospitalizations, the relative rate of a subsequent admission decreases to 3.03 (95% CI (2.01, 4.56)) and 1.90 (95% CI (1.19, 3.03)), respectively. CONCLUSIONS: Young adult survivors of colorectal cancer have an increased risk of experiencing hospitalizations compared to cancer-free controls. However this relative risk decreases as the number of prior hospitalizations increases. The multistate approach is able to use information on the timing of hospitalizations and answer questions that standard Poisson and Negative Binomial models are unable to address. BioMed Central 2012-10-09 /pmc/articles/PMC3472287/ /pubmed/23043307 http://dx.doi.org/10.1186/1472-6963-12-353 Text en Copyright ©2012 Sutradhar et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Sutradhar, Rinku Forbes, Shawn Urbach, David R Paszat, Lawrence Rabeneck, Linda Baxter, Nancy N Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
title | Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
title_full | Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
title_fullStr | Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
title_full_unstemmed | Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
title_short | Multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
title_sort | multistate models for comparing trends in hospitalizations among young adult survivors of colorectal cancer and matched controls |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472287/ https://www.ncbi.nlm.nih.gov/pubmed/23043307 http://dx.doi.org/10.1186/1472-6963-12-353 |
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