Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website https://www.gastrores.org

Original Article

Volume 17, Number 3, June 2024, pages 133-145


The Risk of Infection-Caused Mortality in Gastric Adenocarcinoma: A Population-Based Study

Figures

Figure 1.
Figure 1. Survival curve for infection-caused mortality with age.
Figure 2.
Figure 2. Survival curve for infection-caused mortality with sex.
Figure 3.
Figure 3. Survival curve for infection-caused mortality with marital status.
Figure 4.
Figure 4. Survival curve for infection-caused mortality with race.
Figure 5.
Figure 5. Survival curve for infection-caused mortality with primary site.
Figure 6.
Figure 6. Survival curve for infection-caused mortality with stage.
Figure 7.
Figure 7. Survival curve for infection-caused mortality with surgery.
Figure 8.
Figure 8. Survival curve for infection-caused mortality with radiation.
Figure 9.
Figure 9. Survival curve for infection-caused mortality with chemotherapy.

Tables

Table 1. Clinicopathologic Features of Gastric Adenocarcinoma Patients
 
VariablesAlive (n = 7,427)Pneumonia and influenza (n = 469)Septicemia (n = 263)TB (n = 8)Other infections (n = 114)Other cause of death (n = 51,299)Total (n = 59,580)
All data are presented as n (%) except age presented as mean (standard deviation). NOS: not otherwise specified; TB: tuberculosis.
Age63.64 (12.302)73.37 (9.941)70.47 (10.793)73.25 (13.21)67.46 (12.915)69.14 (12.321)68.49 (12.438)
Sex
  Male5,051 (68)335 (71.4)173 (65.8)6 (75)81 (71.1)34,780 (67.8)40,426 (67.9)
  Female2,376 (32)134 (28.6)90 (34.2)2 (25)33 (28.9)16,519 (32.2)19,154 (32.1)
Race
  White5,212 (70.2)327 (69.7)194 (73.8)4 (50)79 (69.3)39,070 (76.2)44,886 (75.3)
  Black751 (10.1)49 (10.4)49 (18.6)1 (12.5)20 (17.5)6,268 (12.2)7,138 (12)
  Others1,464 (19.7)93 (19.8)20 (7.6)3 (37.5)15 (13.2)5,961 (11.6)7,556 (12.7)
Marital status
  Single956 (12.9)45 (9.6)30 (11.4)-29 (25.4)5,548 (10.8)6,608 (11.1)
  Married5,128 (69)282 (60.1)157 (59.7)5 (62.5)56 (49.1)31,086 (60.6)36,714 (61.6)
  Separated75 (1)6 (1.3)3 (1.1)--723 (1.4)807 (1.4)
  Divorced537 (7.2)29 (6.2)18 (6.8)-7 (6.1)3,723 (7.3)4,314 (7.2)
  Widowed731 (9.8)107 (22.8)55 (20.9)3 (37.5)22 (19.3)10,219 (19.9)11,137 (18.7)
Primary site
  Stomach, NOS12 (10.5)58 (12.4)38 (14.4)-12 (10.5)7,669 (14.9)8,431 (14.2)
  Cardia, NOS40 (35.1)126 (26.9)90 (34.2)3 (37.5)40 (35.1)18,985 (37)2,2451 (37.7)
  Fundus of stomach4 (3.5)6 (1.3)15 (5.7)-4 (3.5)2,151 (4.2)2,389 (4)
  Body of stomach9 (7.9)30 (6.4)24 (9.1)1 (12.5)9 (7.9)3,611 (7)4,206 (7.1)
  Gastric antrum26 (22.8)112 (23.9)49 (18.6)2 (25)26 (22.8)9,979 (19.5)11,695 (19.6)
  Pylorus3 (2.6)27 (5.8)8 (3)-3 (2.6)1,879 (3.7)2,148 (3.6)
  Lesser curvature of stomach, NOS17 (14.9)90 (19.2)23 (8.7)2 (25)17 (14.9)4,867 (9.5)5,768 (9.7)
  Greater curvature of stomach, NOS3 (2.6)20 (4.3)16 (6.1)-3 (2.6)2,158 (4.2)2,492 (4.2)
Stage
  Localized45 (39.5)219 (46.7)89 (33.8)5 (62.5)45 (39.5)10,238 (20)14,351 (24.1)
  Regional37 (32.5)162 (34.5)93 (35.4)2 (25)37 (32.5)16,911 (33)19,680 (33)
  Distant20 (17.5)54 (11.5)57 (21.7)-20 (17.5)20,168 (39.3)21,222 (35.6)
  Unstaged12 (10.5)34 (7.2)24 (9.1)1 (12.5)12 (10.5)3,982 (7.8)4,327 (7.3)
Chemotherapy
  Yes28 (24.6)91 (19.4)88 (33.5)1 (12.5)28 (24.6)18,628 (36.3)22,327 (37.5)
  No/unknown86 (75.4)378 (80.6)175 (66.5)7 (87.5)86 (75.4)32,671 (63.7)37,253 (62.5)
Radiation
  Beam radiation25 (21.9)68 (14.5)61 (23.2)1 (12.5)25 (21.9)10,665 (20.8)13,135 (22)
  Other types of radiation1 (0.9)401 (85.5)--1 (0.9)264 (0.5)307 (0.5)
  None88 (77.2)-202 (76.8)7 (87.5)88 (77.2)40,370 (78.7)46,138 (77.4)
Surgery
  Surgery performed80 (70.2)392 (83.6)197 (74.9)6 (75)80 (70.2)28,462 (55.5)35,350 (59.3)
  Not recommended34 (29.8)77 (16.4)66 (25.1)2 (25)34 (29.8)22,837 (44.5)24,230 (40.7)

 

Table 2. Univariate Analysis Using Kaplan-Meier Test
 
VariablesInfection, mean (95% CI)P-valueOther, mean (95% CI)P-valueTotal, mean (95% CI)P-value
CI: confidence interval; NOS: not otherwise specified.
Age0.8< 0.001< 0.001
  < 4960.452 (32.668 - 88.235)83.313 (78.347 - 88.278)81.759 (76.883 - 86.635)
  > 5056.75 (51.916 - 61.583)44.833 (44.02 - 45.645)42.961 (42.204 - 43.719)
Sex0.030.0150.006
  Male53.247 (47.701 - 58.793)46.606 (45.546 - 47.667)44.591 (43.606 - 45.576)
  Female65.239 (56.123 - 74.356)51.12 (49.537 - 52.702)49.116 (47.625 - 50.607)
Race0.004< 0.001< 0.001
  White54.01 (48.549 - 59.47)44.975 (44.03 - 45.921)43.238 (42.35 - 44.125)
  Black47.218 (33.92 - 60.517)43.29 (40.908 - 45.673)41.3 (39.114 - 43.485)
  Others78.916 (65.925 - 91.907)72.213 (68.744 - 75.681)68.444 (65.234 - 71.653)
Marital status< 0.001< 0.001< 0.001
  Single (never married)33.288 (23.649 - 42.928)45.58 (42.859 - 48.301)43.606 (41.035 - 46.176)
  Married (including common law)62.79 (56.277 - 69.303)54.631 (53.413 - 55.849)52.507 (51.36 - 53.654)
  Separated96.667 (51.308 - 142.025)43.854 (37.585 - 50.123)42.165 (36.285 - 48.045)
  Divorced50.37 (31.031 - 69.71)44.62 (41.197 - 48.044)42.798 (39.623 - 45.973)
  Widowed54.182 (44.342 - 64.021)30.734 (29.528 - 31.94)29.369 (28.257 - 30.48)
Primary site0.001< 0.001< 0.001
  Stomach, NOS52.296 (38.221 - 66.372)33.233 (31.341 - 35.124)31.757 (29.995 - 33.519)
  Cardia, NOS42.39 (35.26 - 49.519)45.815 (44.207 - 47.422)44.159 (42.654 - 45.664)
  Fundus of stomach55.88 (27.061 - 84.699)36.822 (32.945 - 40.699)35.445 (31.805 - 39.085)
  Body of stomach55.328 (38.117 - 72.539)45.474 (42.289 - 48.658)43.43 (40.47 - 46.39)
  Gastric antrum62.492 (52.125 - 72.859)54.493 (52.469 - 56.518)52.249 (50.351 - 54.146)
  Pylorus74.632 (48.34 - 100.923)55.917 (51.099 - 60.734)53.191 (48.725 - 57.658)
  Lesser curvature of stomach, NOS77.886 (64.351 - 91.421)65.8 (62.771 - 68.829)62.473 (59.658 - 65.287)
  Greater curvature of stomach, NOS53.487 (32.172 - 74.803)54.983 (50.669 - 59.297)53.06 (48.942 - 57.178)
Stage< 0.001< 0.001< 0.001
  Localized76.282 (68.403 - 84.161)99.719 (97.222 - 102.216)95.154 (92.828 - 97.481)
  Regional59.83 (51.542 - 68.118)52.013 (50.519 - 53.506)50.024 (48.627 - 51.422)
  Distant15.137 (10.058 - 20.217)13.752 (13.02 - 14.483)13.434 (12.739 - 14.128)
  Unstaged23.901 (13.549 - 34.253)23.683 (21.724 - 25.641)22.556 (20.73 - 24.382)
Chemotherapy0.002< 0.001< 0.001
  Yes61.602 (55.779 - 67.425)48.408 (47.345 - 49.47)46.153 (45.163 - 47.143)
  No/unknown42.231 (35.135 - 49.326)48.691 (46.87 - 50.512)47.178 (45.454 - 48.902)
Radiation0.18< 0.001< 0.001
  Beam radiation44 (44 - 44)35.806 (29.182 - 42.429)35.452 (28.907 - 41.997)
  Other types of radiation59.473 (53.991 - 64.954)46.356 (45.403 - 47.308)44.343 (43.452 - 45.234)
  None45.31 (36.608 - 54.011)53.25 (51.09 - 55.409)51.446 (49.42 - 53.473)
Surgery< 0.001< 0.001< 0.001
  Surgery performed68.252 (62.638 - 73.866)71.184 (69.843 - 72.525)68.191 (66.938 - 69.444)
  Not recommended14.017 (9.726 - 18.307)13.114 (12.454 - 13.774)12.719 (12.103 - 13.334)

 

Table 3. Multivariate Analysis Using Cox Regression Test
 
VariablesInfection, HR (95% CI)Regression coefficientOther, HR (95% CI)Regression coefficientTotal, HR (95% CI)Regression coefficient
*P < 0.01. **P < 0.001. CI: confidence interval; HR: hazard ratio; NOS: not otherwise specified.
Age, reference (< 49)
  > 503.137 (2.178 - 4.517)**1.1431.285 (1.242 - 1.329)**0.2511.299 (1.256 - 1.344)**0.262
Sex, reference (male)
  Female0.658 (0.561 - 0.773)**-0.4180.886 (0.869 - 0.905)**-0.1210.882 (0.865 - 0.9)**-0.125
Race, reference (white)
  Black1.202 (0.979 - 1.474)0.1840.993 (0.966 - 1.02)-0.0070.995 (0.969 - 1.023)-0.005
  Other0.968 (0.795 - 1.177)-0.0330.81 (0.788 - 0.833)**-0.2110.813 (0.791 - 0.836)**-0.207
Marital status, reference (single)
  Married0.627 (0.506 - 0.778)**-0.4660.927 (0.9 - 0.954)**-0.0760.921 (0.895 - 0.948)**-0.082
  Separated0.564 (0.285 - 1.119)-0.5720.997 (0.922 - 1.078)-0.0030.987 (0.914 - 1.067)-0.013
  Divorced0.742 (0.533 - 1.032)-0.2991.026 (0.984 - 1.07)0.0261.021 (0.979 - 1.064)0.02
  Widowed1.079 (0.841 - 1.386)0.0761.202 (1.162 - 1.244)**0.1841.2 (1.16 - 1.241)**0.182
Primary site, reference (stomach, NOS)
  Cardia, NOS0.898 (0.71 - 1.137)-0.1070.881 (0.857 - 0.906)**-0.1270.881 (0.857 - 0.906)**-0.126
  Fundus of stomach0.831 (0.537 - 1.285)-0.1850.993 (0.947 - 1.042)-0.0070.991 (0.945 - 1.039)-0.009
  Body of stomach1.047 (0.767 - 1.429)0.0460.93 (0.894 - 0.968)**-0.0720.932 (0.896 - 0.969)**-0.07
  Gastric antrum0.923 (0.725 - 1.175)-0.080.897 (0.87 - 0.925)**-0.1090.897 (0.87 - 0.925)**-0.109
  Pylorus0.961 (0.662 - 1.394)-0.040.907 (0.862 - 0.954)**-0.0970.908 (0.863 - 0.955)**-0.097
  Lesser curvature of stomach, NOS1.087 (0.839 - 1.409)0.0830.81 (0.781 - 0.84)**-0.2110.815 (0.786 - 0.845)**-0.205
  Greater curvature of stomach, NOS0.904 (0.625 - 1.308)-0.1010.896 (0.854 - 0.941)**-0.1090.896 (0.854 - 0.94)**-0.11
Stage, reference (localized)
  Regional1.121 (0.952 - 1.32)0.1142.085 (2.032 - 2.139)**0.7352.054 (2.003 - 2.106)**0.72
  Distant1.217 (0.957 - 1.549)0.1963.554 (3.453 - 3.657)**1.2683.492 (3.394 - 3.592)**1.25
  Unstaged1.699 (1.278 - 2.258)**0.531.837 (1.766 - 1.912)**0.6081.825 (1.755 - 1.898)**0.601
Chemotherapy, reference (yes)
  No/unknown1.669 (1.356 - 2.056)**0.5121.76 (1.72 - 1.8)**0.5651.756 (1.717 - 1.796)**0.563
Radiation, reference (beam)
  Other types of radiation0.285 (0.04 - 2.038)-1.2551.085 (0.96 - 1.225)0.0811.074 (0.95 - 1.213)0.071
  None0.892 (0.715 - 1.113)-0.1141.057 (1.031 - 1.083)**0.0551.055 (1.03 - 1.081)**0.054
Surgery, reference (yes)
  Not recommended1.412 (1.132 - 1.761)*0.3452.728 (2.661 - 2.796)**1.0032.705 (2.639 - 2.773)**0.995

 

Table 4. The Probability of Infection Using Binary Regression Test
 
VariablesInfection, OR (95% CI)Regression coefficient
*P < 0.05. **P < 0.01. ***P < 0.001. CI: confidence interval; OR: odds ratio; NOS: not otherwise specified.
Age, reference (< 49)
  > 502.094 (1.453 - 3.018)***0.739
Sex, reference (male)
  Female0.789 (0.671 - 0.928)**-0.237
Race, reference (white)
  Black1.212 (0.985 - 1.49)0.192
  Other1.226 (1.006 - 1.494)*0.204
Marital status, reference (single)
  Married0.715 (0.574 - 0.89)**-0.335
  Separated0.545 (0.273 - 1.086)-0.607
  Divorced0.75 (0.538 - 1.047)-0.287
  Widowed0.874 (0.679 - 1.125)-0.134
Primary site, reference (stomach, NOS)
  Cardia, NOS0.903 (0.713 - 1.144)-0.102
  Fundus of stomach0.796 (0.513 - 1.236)-0.228
  Body of stomach1.128 (0.824 - 1.545)0.121
  Gastric antrum1.002 (0.786 - 1.277)0.002
  Pylorus1.04 (0.713 - 1.515)0.039
  Lesser curvature of stomach, NOS1.325 (1.02 - 1.721)*0.282
  Greater curvature of stomach, NOS1.026 (0.707 - 1.488)0.025
Stage, reference (localized)
  Regional0.561 (0.478 - 0.66)***-0.577
  Distant0.354 (0.284 - 0.442)***-1.039
  Unstaged0.95 (0.716 - 1.261)-0.051
Chemotherapy, reference (yes)
  No/unknown1.258 (1.029 - 1.538)*0.23
Radiation, reference (beam)
  Other types of radiation0.259 (0.036 - 1.86)-1.351
  None0.844 (0.677 - 1.054)-0.169
Surgery, reference (yes)
  Not recommended0.549 (0.447 - 0.673)***-0.601