Evidence map›Paper›PMID 30355276›Full record

ArticleBMC cancer2018

Preadmission antidepressant use and bladder cancer: a population-based cohort study of stage at diagnosis, time to surgery, and surgical outcomes.

Ellen Hollands Steffensen, Clint Cary, Jørgen Bjerggaard Jensen, Heidi Larsson, Michael Weiner, Mette Nørgaard

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Ellen Hollands SteffensenDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. ehollandssteffensen@gmail.com.ORCID http://orcid.org/0000-0003-0216-9646
Clint CaryDepartment of Urology, Indiana University School of Medicine, Indianapolis, IN, USA and Regenstrief Institute, Inc, Indianapolis, IN, USA.
Jørgen Bjerggaard JensenDepartment of Urology, Aarhus University Hospital, Aarhus, Denmark and Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
Heidi LarssonDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark and The Danish National Registries - a National Quality Improvement Programme (RKKP), Aarhus, Denmark.
Michael WeinerIndiana University School of Medicine, Indianapolis, IN, USA and Regenstrief Institute, Inc, Indianapolis, IN, USA.
Mette NørgaardDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Aarhus University Hospital · DKRegenstrief Institute · US

Funding

Christian Larsen & Judge Ellen Larsens Foundation 5011780Sundhed og Sygdom, Det Frie Forskningsråd 6110-00040The University of Copenhagen foundation for medical students A4996
6 · The paper itself

Abstract

backgroundAmong cancer patients, prior antidepressant use has been associated with impaired survival. This could be due to differences in stage at diagnosis, in receipt of treatment, or in treatment complications. The purpose of this study was, therefore, to examine if preadmission antidepressant use in patients with bladder cancer is associated with tumor stage at diagnosis, rate of cystectomy, and surgical outcomes, including survival.

methodsWe performed a registry-based cohort study including all patients with incident invasive bladder cancer in Denmark 2005-2015. Exposure was defined as redemption of two or more antidepressant prescriptions one year before cancer diagnosis. We compared tumor stage using logistic regression, postsurgical inpatient length of stay using linear regression, and other outcomes using Cox regression. All results were adjusted for age, sex, comorbidity, and marital status.

resultsAmong 10,427 bladder cancer patients, 10% were antidepressant users. At diagnosis, 51% of users and 52% of non-users had muscle-invasive disease. However, upon adjustment for age, sex, comorbidity, and marital status, users had lower odds of muscle-invasive disease (adjusted odds ratio 0.86 (95% confidence interval (CI) 0.74-0.99)). Among patients with muscle-invasive disease, fewer users than non-users had surgery within three months (15% vs. 24%, adjusted hazard ratio (aHR) 0.75 (95% CI 0.59-0.95)). Of 2532 patients undergoing surgery, 6% were antidepressant users. Postsurgical inpatient length of stay did not differ between users and non-users. The 30-day cumulative incidence of readmission was higher for users (41% vs. 33%, aHR 1.33 (95% CI 1.05-1.67)), while the 90-day incidence of postoperative procedures was 44% for users and 38% for non-users (aHR 1.18 (95% CI 0.93-1.51)). One-year mortality was comparable in users (15%) and non-users (14%).

conclusionsAntidepressant use in bladder cancer patients was associated with less advanced stage at diagnosis and lower rate of cystectomy. After cystectomy, users had higher rate of readmission and postoperative procedures than non-users, but we found no difference in length of stay or one-year mortality. The results point to the importance of differentiated clinical care according to individual patient characteristics.

Indexed as

AdolescentAdultAgedAged, 80 and overAntidepressive AgentsCohort StudiesCystectomyDenmarkFemaleHumansMaleMiddle AgedTreatment OutcomeUrinary Bladder NeoplasmsYoung AdultAntidepressive AgentsAntidepressive agentsCystectomyDelayed diagnosisTreatment outcomeUrinary bladder neoplasms

Identifiers

PMID30355276
PMCPMC6201496
OpenAlexW2897919388

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.