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Abstract #157517

Yassa Ndjakani, MD, MPH¹, Frank Charlie Bandiera², William N. Mkanta, PhD², Kevon Jackman, BS², Daniel Blumenthal, MD, MPH¹, Unyime O. Nseyo, MD³, and Nabih Asal, PhD². (1) Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310-1495, 404-752-1959, ndjakay@msm.edu, (2) EPIDEMIOLOGY AND BIOSTATISTICS, UNIVERSITY OF FLORIDA, 2725 SW 27 AVE # F5, Gainesville, FL 32608, (3) Division of Urology, University of Florida Medical School, 1600 S.W. Archer Road, P.O. Box 100247, Gainesville, VA 32610-0247

Objectives: Previous studies have demonstrated that co-morbidity is related to poorer survival among patients with prostate cancer. We evaluated aspects of co-morbidity in patients who died from prostate cancer as compared to hospital controls.

Methods: Using retrospective case-control hospital-based methodology, we compared 404 prostate cancer patients to 404 age/race frequency-matched controls. Cases were identified through 1998-2001 death certificates and medical records abstracts gathered in Atlanta and North Florida hospitals. Racial and age-specific differences in the level of co-morbidity were computed. Logistic regression was used to measure their impact on mortality.

Results: Cases had more co-morbidities (10.33 vs. 2.63; p<.05), except for stroke (1.5 vs. 12.6; p <.05) and cardiovascular disease (no difference). Cases had more co-morbidity within both races (11.16 vs. 2.83 whites; 9.03 vs. 2.35 blacks). However, white cases had slightly more, but significant number of co-morbidities compared to blacks (11.16 vs. 9.03; p=.044). Both younger (50-64 years) and older adults (65 years or older) had higher level of co-morbidity among the cases. Co-morbidity was a strong predictor of the risk of death from prostate cancer, independent of age. Logistic regression showed that the odds of dying increase by 15% for each additional co-morbid condition.

Conclusion: Results indicated that persons that died from prostate cancer have more co-morbidities than persons that did not die from prostate cancer. There were differences in disease-specific co-morbidities between cases and controls, indicating that persons that die from prostate cancer have a heavier disease burden than persons that did not die from prostate cancer.

Learning Objectives:

• List aspects of co-morbid conditions that are associated with patients who die from prostate cancer.
• Articulate the procedure used in linking death records with hospital charts and matching cases with controls in a hospital-based case-control study.
• Articulate the procedure used to measure the impact of co-morbidity on mortality from prostate cancer using logistic regression methods.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.