TABLE 4.
Multivariable logistic regression predictors of adherence to CoC Quality Measure 3 and influence on all-cause mortality as predicted by Cox proportional hazards modeling
| Suirgery not used a is first line therapy for N2 disease n = 153.355 |
|||||
|---|---|---|---|---|---|
| Sampley percentage | Failure percentage | Failure proportion P value | Odds ratio for failure (95% CI) | Hazard ratio for failure (95% CI) | |
| Sex | .40 | ||||
| Male | 57.79 | 2.49 | 1.04 (0.97–1.11) | 1.13 (1.11–1.14) | |
| Female | 42.21 | 2.55 | Reference | Reference | |
| Age, y | <.001 | ||||
| <40 | 0.44 | 1.97 | 0.9 (0.55–1.46) | 0.93 (0.90–0.97) | |
| 40–49 | 5.15 | 2.25 | 1.04 (0.88–1.24) | 0.93 (0.90–0.96) | |
| 50–59 | 14.22 | 2.17 | Reference | Reference | |
| 60–69 | 31.08 | 2.61 | 1.18 (1.07–1.31) | 1.18 (1.16–1.21) | |
| 70–79 | 38.18 | 2.88 | 1.31 (1.18–1.46) | 1.53 (1.50–1.56) | |
| ≥80 | 11.49 | 1.98 | 0.93 (0.80–1.07) | 2.06 (2.00–2.11) | |
| Race and ethnicity | <.001 | ||||
| Non-Hispanic white | 85.53 | 2.59 | Reference | Reference | |
| Non-Hispanic black | 8.72 | 1.87 | 0.71 (0.63–0.82) | 0.97 (0.95–1.00) | |
| Hispanic | 2.38 | 2.99 | 1.20 (0.98–1.46) | 0.94 (0.89–0.99) | |
| Asian | 1.51 | 2.67 | 1.01 (0.78–1.30) | 0.84 (0.78–0.89); | |
| Other/unknown | 1.21 | 2.75 | 1.03 (0.76–1.40) | 0.97 (0.91–1.03) | |
| Zip Code income quartile | .01 | ||||
| Lowest quartile | 16.47 | 2.46 | 1.06 (0.80–1.25) | 1.05 (1.02–1.10) | |
| Second quartile | 18.68 | 2.36 | 0.97 (0.84–1.12) | 1.03 (1.01–1.07) | |
| Third quartile | 26.64 | 2.42 | 0.99 (0.90–1.10) | 1.02(1.00–1.04) | |
| Highest quartile | 33.57 | 2.72 | Reference | Reference | |
| Other/unknown | 4.69 | 2.49 | 0.16(0.04–0.71) | 1.20 (0.49–2.96) | |
| Zip Code education quartile | .25 | ||||
| Lowest quartile | 18.50 | 2.41 | 0.99 (0.84–1.16) | 1.07 (1.04–1.10) | |
| Second quartile | 24.72 | 2.46 | 1.01 (0.89–1.48) | 1.06 (1.03–1.08) | |
| Third quartile | 23.22 | 2.48 | 1.00 (0.89–1.11) | 1.05 (1.03–1.07) | |
| Highest quartile | 27.48 | 2.66 | Reference | Reference | |
| Other/unknown | 4.70 | 2.51 | 5.80 (1.30–24.04) | 0.88 (0.35–2.18) | |
| Insurance status | <001 | ||||
| Medicaid or not insured | 93.15 | 2.56 | 0.88 (0.78–1.02) | 1.17 (1.14–1.20) | |
| Other types of insurance | 6.85 | 2.01 | Reference | Reference | |
| Tumor size, cm | <.001 | ||||
| ≤1 | 8.28 | 0.83 | Reference | Reference | |
| 2 | 3.09 | 4.94 | 0.79 (0.75–0.82) | 0.94 (0.89–1.00) | |
| 3 | 15.47 | 4.98 | 0.62 (0.59–0.65) | 0.99 (0.94–1.05); | |
| 5 | 19.41 | 3.92 | 0.48 (0.45–0.50) | 1,09 (1.03–1.15) | |
| 7 | 25.29 | 2.88 | 0.40 (0.38–0.42) | 1.24 (1.18–1.31) | |
| ≥8 | 14.12 | 2.27 | 0.37 (0.35–0.39) | 1.37 (1.30–1.45) | |
| Other/unknown | 12.10 | 2.22 | 1.67 (1.52–1.83) | 1.43 (1,36–1.51) | |
| Hospital location | .002 | ||||
| Large urban region | 47.00 | 2.66 | Reference | Reference | |
| Medium urban region | 17.54 | 2.25 | 0.85 (0.73–0.98) | 1.04 (1.02–1.07) | |
| Small urban region | 27.68 | 2.43 | 0.93 (0.82–1.05) | 1.02 (1.00–1.05) | |
| Rural region | 2.62 | 2.74 | 0.99 (0.78–1.291 | 1.00 (0.96–1.05) | |
| Other/unknown | 5.16 | 2.60 | 0.98 (0.73–1.08) | 0.99 (0.95–1.03) | |
| Type of Hospital | <.001 | ||||
| Community | 63.42 | 2.19 | Reference | Reference | |
| Academic | 36.58 | 3.39 | 1.56 (1.34–1.81) | 0.90 (0.88–0.93) | |
| Travel distance, miles | <.001 | ||||
| >5 | 28.20 | 2.07 | 1.26 (1.16–1.37) | 0.94 (0.922–0.95) | |
| <5 | 71.80 | 2.74 | Reference | Reference | |
| Time period* | <.001 | ||||
| 1998–2000 | 18.83 | 2.51 | Reference | Reference | |
| 2001–2003 | 22.53 | 2.45 | 0.93 (0.83–1.05) | 0.95 (0.94–0.97) | |
| 2004–2006 | 21.59 | 2.11 | 0.75 (0.65–0.85) | 0.89 (0.87–0.91) | |
| 2007–2009 | 23.77 | 2.70 | 0.93: (0.82–1.06) | Omitted* | |
| 2010–2011 | 15.59 | 2.94 | 0.97 (0.83–1.12) | Omitted* | |
| Surgery not used as first-line therapy for N2 disease | 0.80 (0.77–0.82) | ||||
CI, Confidence interval.
*
NCDB survival data only available for patients diagnosed from 1998–2006. Survival analysis n = 96,229.