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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Trauma+Manag+Outcomes
2015 ; 9
(ä): 8
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A comparison between survival from cancer before and after a physical traumatic
injury: physical trauma before cancer is associated with decreased survival
#MMPMID26543499
Delahanty DL
; Marley R
; Fenton A
; Salvator A
; Woofter C
; Erck D
; Coleman J
; Muakkassa F
J Trauma Manag Outcomes
2015[]; 9
(ä): 8
PMID26543499
show ga
BACKGROUND: Prior traumatic experiences have been associated with poorer coping
strategies, greater distress, and more posttraumatic stress disorder (PTSD)
symptoms following a subsequent cancer diagnosis affecting their survival.
However, the impact of prior physical traumatic injury on cancer survival has not
been examined. METHODS: The present study matched patients from the same Level 1
Trauma center who appeared in both the trauma and cancer registries. A total of
498 patients met the criteria between 1998 and 2014 who have experienced both a
diagnosis of cancer and a physical traumatic injury. The survival between the
patients who had physical trauma before cancer (TBC) versus those that had
physical trauma after the cancer diagnosis (TAC) were compared. RESULTS: The TBC
group had a higher percentage of males (48 % vs 33 % p?=?0.001) and motor vehicle
collisions (18 % vs 7 %, p?0.001), than the TAC group. TBC patients were also
significantly younger than TAC patients at the time of the physical traumatic
event (68.7?±?14.6 vs 76.2?±?12.0 years, p?0.001), and longer length of time
between the cancer diagnosis and physical traumatic injury (2.9?±?2.9 vs
1.7?±?2.6 years, p?0.001). The overall probability of survival for the entire
sample was 68 %. Percent survival for the TBC (n?=?251) and TAC (n?=?247) groups
was 56 and 80 % respectively (p?0.001). Results were consistent regardless of
stage of cancer at diagnosis (hazard ratio (HR (Standard Error)). After adjusting
for comorbidities Charlson comorbidity index (CCI) (HR?=?1.2 (0.06), p?=?0.009)),
cancer stage (HR?=?2.8 (0.12), p?0.001)), lung cancer (HR?=?1.7 (0.25),
p?0.001) and bladder cancer (HR?=?3.5 (0.55), p?=?0.02), experiencing a prior
physical traumatic injury was associated with an increased HR for mortality of
4.6 (0.93), p?0.001). CONCLUSIONS: A physical traumatic episode before cancer
diagnosis (TBC) increased the risk of death 4.6 fold compared to the TAC group
even after adjusting for CCI, stage of cancer at diagnosis, lung cancer, and
bladder cancer. These findings suggest considering a history of physical
traumatic injury in cancer patients as a possible risk factor for faster cancer
progression and mortality.