Gerontopole, Centre Hospitalier Universitaire de Toulouse, France.
J Gerontol A Biol Sci Med Sci. 2013 Sep;68(9):1129-33. doi: 10.1093/gerona/glt073. Epub 2013 Jun 3.
Screening tools for the identification of vulnerable older patients with cancer are needed. Aim of this study is to measure the prognostic value of multiple screening tools for the assessment of mortality risk in oncogeriatrics.
The prognostic value of the following assessment tools was tested in 200 older women with gynecological cancer (mean age = 73.5 years) for 1-year mortality: Short Physical Performance Battery, usual gait speed, handgrip strength, Eastern Cooperative Oncology Group Performance Status scale, Karnofsky Performance Status scale, Vulnerable Elders Scale-13, activities of daily living, and instrumental activities of daily living. Cox proportional hazard models were performed to estimate the associations of the performance measures with mortality. Areas under receiver operating characteristic curves were also estimated.
Twenty-three participants (11.5%) died during the follow-up. The Short Physical Performance Battery, usual gait speed, and instrumental activities of daily living were the only parameters significantly associated with mortality, even after adjustment for confounders. No statistically significant results were reported for other functional measures. Similar results were obtained when testing the predictive values of the performance measures at the receiver operating characteristic analyses.
The Short Physical Performance Battery and especially the usual gait speed may represent promising tools for measuring the mortality risk of older cancer patients, thus potentially supporting clinical decisions. Further studies are needed to confirm and extend the present findings.
需要用于识别有癌症的脆弱老年患者的筛查工具。本研究的目的是衡量多种筛查工具在评估肿瘤老年患者的死亡风险方面的预后价值。
在 200 名患有妇科癌症的老年女性(平均年龄=73.5 岁)中测试了以下评估工具的预后价值,以评估 1 年死亡率:简短体能状况量表、常用步速、握力、东部合作肿瘤学组体能状态量表、卡诺夫斯基体能状态量表、脆弱老年人量表-13、日常生活活动和工具性日常生活活动。进行 Cox 比例风险模型以估计各项表现指标与死亡率的关联。还估计了受试者工作特征曲线下的面积。
在随访期间,有 23 名参与者(11.5%)死亡。简短体能状况量表、常用步速和工具性日常生活活动是唯一与死亡率显著相关的参数,即使在调整混杂因素后也是如此。其他功能指标则未报告统计学显著结果。在受试者工作特征分析中测试表现指标的预测值时,也得到了类似的结果。
简短体能状况量表,尤其是常用步速,可能是衡量老年癌症患者死亡风险的有前途的工具,从而可能支持临床决策。需要进一步的研究来证实和扩展本研究的发现。