title: The impact of the type of hospital on survival of multiple myeloma patients: the MICORE study.
abstract: OBJECTIVE
  To analyze the impact of the type of hospital in overall survival of multiple myeloma patients.
  
  
  METHODS
  A survival analysis was performed of all patients (n=431) diagnosed in 5 public hospitals (4 community hospitals and one university hospital) during the period 1993-2006.
  
  
  RESULTS
  Patients attended to in community hospitals differ significantly from those seen in the university hospital in the following variables: mean age (70 years [31-92] versus 67.9 (35-91), P=.038); percentage of stage iii patients (62.6% versus 69.1%, P=.033), and percentage of patients who had autologous stem cell transplant (8.2% versus 18.2%, P=.026). The variables associated with mortality in the multivariate analysis were age (P<.001), stage (iii versus i; P=.03) and renal failure (P=.04). The type of hospital did not reach statistical significance (hazard ratio of 0.72 (95% confidence interval 0.48-1.07), P=.1].
  
  
  CONCLUSIONS
  The type of hospital is not significantly associated with mortality in multiple myeloma patients. These data support our current model of health care, in which the community hospitals are responsible for the primary care of these patients, in a coordinated work with the university hospital.
authors.affiliation: Servicio de Hematología-Hemoterapia, Hospital Universitario Virgen de las Nieves, Granada, España; Servicio de Hematología-Hemoterapia, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, España. Electronic address: rafael.rios.sspa@juntadeandalucia.es.
authors.forename: R
authors.initials: R
authors.lastname: Ríos
authors.forename: M
authors.initials: M
authors.lastname: González-Silva
authors.forename: E
authors.initials: E
authors.lastname: Molina
authors.forename: J R
authors.initials: JR
authors.lastname: García-Fernández
authors.forename: M E
authors.initials: ME
authors.lastname: Clavero
authors.forename: J M
authors.initials: JM
authors.lastname: Durán
authors.forename: F
authors.initials: F
authors.lastname: López-Berenguel
authors.forename: M M
authors.initials: MM
authors.lastname: Romero
authors.forename: J J
authors.initials: JJ
authors.lastname: Jiménez-Moleón
authors.forename: M J
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: J
authors.initials: J
authors.lastname: Sáinz
authors.forename: M
authors.initials: M
authors.lastname: Jurado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate
keywords: Análisis de supervivencia; Hospital; Mieloma múltiple; Multiple myeloma; Survival analysis