Nomogram predicting the cardiovascular disease mortality for older patients with colorectal cancer: A real-world population-based study

Table 1 Clinicopathologic characteristics of patients with different outcomes, n (%)

Variables	Cancer-specific mortality (n = 41459)	CVD-specific mortality (n = 12651)	Others-specific mortality (n = 14106)	Survivors (n = 73035)	Total (n = 141251)
Age at diagnosis (years)
60-69	14188 (34.2)	1911 (15.1)	2750 (19.5)	35112 (48.1)	53961 (38.2)
70-79	13969 (33.7)	3971 (31.4)	4895 (34.7)	25384 (34.8)	48219 (34.1)
≥ 80	13302 (32.1)	6769 (53.5)	6461 (45.8)	12539 (17.1)	39071 (27.7)
Sex
Female	21112 (50.9)	6395 (50.5)	7294 (51.7)	37631 (51.5)	72432 (51.3)
Male	20347 (49.1)	6256 (49.5)	6812 (48.3)	35404 (48.5)	68819 (48.7)
Marital status
Single	4908 (11.8)	1296 (10.2)	1431 (10.1)	7802 (10.7)	15437 (10.9)
Married	19950 (48.1)	5414 (42.8)	6312 (44.7)	41601 (57)	73277 (51.9)
Others	16601 (40.1)	5941 (47)	6363 (45.2)	23632 (32.3)	52537 (37.2)
Race
White	33337 (80.4)	10670 (84.3)	11818 (83.8)	58562 (80.2)	114387 (81)
Black	4928 (11.9)	1232 (9.8)	1318 (9.3)	7158 (9.8)	14636 (10.4)
Others	3197 (7.7)	749 (5.9)	970 (6.9)	7315 (10)	12228 (8.6)
Year of diagnosis
2004-2007	16825 (40.6)	6651 (52.6)	7135 (50.6)	16055 (22)	46666 (33)
2008-2011	14971 (36.1)	4215 (33.3)	4873 (34.5)	23245 (31.8)	47304 (33.5)
2011-2016	9663 (23.3)	1785 (14.1)	2098 (14.9)	33735 (46.2)	47281 (33.5)
Insurance status
Insured	27713 (66.8)	7290 (57.6)	8303 (58.9)	59691 (81.7)	102997 (72.9)
Uninsured	576 (1.4)	45 (0.4)	78 (0.6)	1030 (1.4)	1729 (1.2)
Unknown	13170 (31.8)	5316 (42)	5725 (40.5)	12314 (16.9)	36525 (25.9)
Primary site
Right half colon	20201 (48.7)	6787 (53.6)	7596 (53.8)	35512 (48.6)	20096 (49.6)
Left half colon	10320 (24.9)	3254 (25.7)	3530 (25)	19442 (26.6)	36546 (25.9)
Rectum	10938 (26.4)	2610 (20.6)	2980 (21.2)	18081 (24.8)	34609 (24.5)
TNM stage
I	3391 (8.2)	4101 (32.4)	4414 (31.3)	24426 (33.4)	36332 (25.7)
II	7956 (19.2)	4755 (37.6)	5207 (36.9)	25190 (34.5)	43108 (30.5)
III	14313 (34.5)	3216 (25.4)	3657 (25.9)	20502 (28.1)	41688 (29.5)
IV	15799 (38.1)	579 (4.6)	828 (5.9)	2917 (4)	20123 (14.3)
Grade
Well	2399 (5.8)	1314 (10.4)	1459 (10.3)	8479 (11.6)	13651 (9.7)
Moderate	26863 (64.8)	9080 (71.8)	10068 (71.4)	53387 (73.1)	99398 (70.4)
Poorly	10709 (25.8)	2043 (16.1)	2297 (16.3)	9734 (13.3)	24783 (17.5)
Undifferentiated	1488 (3.6)	214 (1.7)	282 (2)	1435 (2)	3419 (2.4)
Histology
Adenocarcinoma	32932 (79.4)	9709 (76.7)	10920 (77.4)	56050 (76.7)	109611 (77.6)
Mucinous adenocarcinoma and signet-ring cell carcinoma	4075 (9.8)	1073 (8.5)	112 (7.9)	5174 (7.1)	11434 (8.1)
Others	4452 (10.8)	1869 (14.8)	2074 (14.7)	11811 (16.2)	20206 (14.3)
Surgery
Yes	36485 (88)	12112 (95.7)	13507 (95.8)	71367 (97.7)	133471 (94.5)
No	4974 (12)	539 (4.3)	599 (4.2)	1668 (2.3)	7780 (5.5)
Radiotherapy
Yes	6094 (14.7)	929 (7.3)	1202 (8.5)	9064 (12.4)	17289 (12.2)
No	35365 (85.3)	11722 (92.7)	12769 (91.5)	63971 (87.6)	123962 (87.8)
Chemotherapy
Yes	19038 (45.9)	2036 (16.1)	2593 (18.4)	24410 (33.4)	48077 (34)
No	22421 (54.1)	10615 (83.9)	11513 (81.6)	48625 (66.6)	93174 (66)

CVD: Cardiovascular disease.

Table 2 Competing risk analysis on the cancer-specific mortality and cardiovascular mortality

Variables	Univariate analysis (cancer-specific mortality)			Univariate analysis (CVD-specific mortality)			Multivariate analysis (cancer-specific mortality)			Multivariate analysis (CVD-specific mortality)
	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value
Age at diagnosis (years)
60-69	Reference			Reference			Reference			Reference
70-79	1.17	1.14-1.2	< 0.001	2.52	2.36-2.69	< 0.001	1.34	1.3-1.37	< 0.001	2.44	2.29-2.61	< 0.001
≥ 80	1.63	1.58-1.67	< 0.001	7.31	6.88-7.77	< 0.001	1.94	1.88-2	< 0.001	6.43	6.02-6.85	< 0.001
Sex
Female	Reference						Reference			Reference
Male	1.03	1.1-1.05	< 0.01	1.07	1.02-1.11	< 0.01	1.16	1.13-1.19	< 0.001	1.58	1.51-1.65	< 0.001
Marital status
Single	Reference			Reference			Reference			Reference
Married	0.77	0.74-0.80	< 0.001	0.72	0.67-0.77	< 0.001	0.83	0.80-0.86	< 0.001	0.68	0.63-0.73	< 0.001
Others	0.98	0.94-1.02	0.31	1.28	1.19-1.38	< 0.001	0.98	0.94-1.01	0.21	0.93	0.87-1.00	0.06
Race
Black	Reference			Reference			Reference			Reference
White	0.82	0.79-0.85	< 0.001	1.05	0.98-1.12	0.2	0.84	0.81-0.88	< 0.001	0.89	0.83-0.96	< 0.001
Others	0.71	0.68-0.75	< 0.001	0.66	0.50-0.74	< 0.001	0.73	0.69-0.77	< 0.001	0.63	0.57-0.71	< 0.001
Year of diagnosis
2004-2007	Reference			Reference			Reference			Reference
2008-2011	0.92	0.9-0.95	< 0.001	0.86	0.82-0.91	< 0.001	0.89	0.87-0.91	< 0.001	0.89	0.85-0.94	< 0.001
2012-2015	0.85	0.83-0.88	< 0.001	0.73	0.68-0.78	< 0.001	0.82	0.8-0.85	< 0.001	0.79	0.74-0.85	< 0.001
Primary site
Right half colon	Reference			Reference			Reference			Reference
Left half colon	0.93	0.9-0.95	< 0.001	0.84	0.80-0.89	< 0.001	0.99	0.96-1.02	0.39	1.02	0.97-1.07	0.44
Rectum	1.07	1.04-1.1	< 0.001	0.76	0.72-0.80	< 0.001	1.08	1.04-1.12	< 0.001	1.06	0.99-1.13	0.08
TNM stage
I	Reference			Reference			Reference			Reference
II	2.09	1.99-2.19	< 0.001	1.05	1.00-1.11	0.05	1.39	1.29-1.49	< 0.001	1.03	0.98-1.09	0.26
III	4.39	4.19-4.59	< 0.001	0.86	0.81-0.90	< 0.001	2.46	2.28-2.65	< 0.001	0.78	0.63-0.98	0.04
IV	18.42	17.61-19.27	< 0.001	0.73	0.65-0.81	< 0.001	9.26	8.61-9.95	< 0.001	0.87	0.72-1.06	0.17
Grade
Well	Reference			Reference			Reference			Reference
Moderate	1.64	1.56-1.72	< 0.001	1.05	0.98-1.13	0.14	1.26	1.2-1.33	< 0.001	1.05	0.99-1.13	0.15
Poorly	3.11	2.95-3.28	< 0.001	1.14	1.05-1.24	< 0.001	1.65	1.56-1.74	< 0.001	1.08	0.98-1.13	0.07
Undifferentiated	3.48	3.22-3.76	< 0.001	1.11	0.93-1.31	0.25	1.81	1.68-1.96	< 0.001	1.11	0.93-1.32	0.26
Histology
Adenocarcinoma	Reference			Reference			Reference			Reference
Mucinous adenocarcinoma and signet-ring cell carcinoma	1.26	1.21-1.31	< 0.001	1.14	1.06-1.23	< 0.001	1.05	1.01-1.09	0.01	1.13	1.05-1.22	< 0.01
Others	0.71	0.68-0.74	< 0.001	1	0.94-1.06	0.95	1.01	0.97-1.04	0.77	1.01	0.95-1.07	0.77
Surgery
Yes	Reference			Reference			Reference			Reference
No	4.24	4.09-4.4	< 0.001	1.74	1.57-1.94	< 0.001	3.46	3.32-3.62	< 0.001	2.07	1.86-2.32	< 0.001
Radiotherapy
Yes	Reference			Reference			Reference			Reference
No	1.22	1.18-1.26	< 0.001	0.57	0.52-0.61	< 0.001	1.17	1.12-1.22	< 0.001	0.99	0.89-1.10	0.9
Chemotherapy
Yes	Reference			Reference			Reference			Reference
No	1.66	1.62-1.7	< 0.001	0.39	0.37-0.41	< 0.001	1.66	1.64-1.68	< 0.001	0.51	0.47-0.55	< 0.001

CVD: Cardiovascular disease.