Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Solidage Research Group on Frailty and Aging, Jewish General Hospital, Montreal, Canada.
Solidage Research Group on Frailty and Aging, Jewish General Hospital, Montreal, Canada; Division of Geriatric Medicine, Jewish General Hospital, McGill University, Montreal, Canada; Department of Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Canada.
J Geriatr Oncol. 2013 Oct;4(4):319-26. doi: 10.1016/j.jgo.2013.07.003. Epub 2013 Aug 12.
To determine the association between self-rated health (SRH) and functional status, comorbidity, toxicity of treatment and mortality in older patients with newly-diagnosed cancer.
Patients aged 65 and over, newly diagnosed were recruited at the Jewish General Hospital, Montreal, Canada. SRH and functional status [instrumental activities of daily living (IADL), basic activities of daily living (ADL), Eastern Cooperative Oncology Group performance status (ECOG PS), frailty markers and number of comorbid conditions] were evaluated prior to the start of treatment, and at 3, 6 and 12 months (SRH only). Treatment toxicity and mortality data were abstracted from the chart. Logistic regression was also used to examine the relationship between functional status, comorbidity and SRH at baseline. Logistic and Cox regression were used to examine the association between baseline SRH and treatment toxicity/time to death.
There were 112 participants enrolled on this study (median age 74.1). At baseline, 74 patients (66.1%) had a good SRH and 38 patients (33.9%) had poor SRH. Only an increasing number of comorbid conditions was associated with poor SRH at baseline in both univariate and multivariable analysis. We found no association between SRH and toxicity or mortality.
A substantial proportion had poor SRH prior to and during cancer treatment. An increasing number of comorbidities was associated with poor SRH at baseline. SRH did not predict toxicity or mortality. Attention to comorbid conditions in older patients with cancer is warranted considering their impact on SRH in this population.
确定自评健康(SRH)与功能状态、合并症、治疗毒性和老年新发癌症患者死亡率之间的关系。
在加拿大蒙特利尔的犹太综合医院招募了年龄在 65 岁及以上、新诊断为癌症的患者。在开始治疗之前以及治疗后 3、6 和 12 个月(仅 SRH)评估了 SRH 和功能状态[工具性日常生活活动(IADL)、基本日常生活活动(ADL)、东部合作肿瘤学组表现状态(ECOG PS)、虚弱标志物和合并症数量]。从图表中提取了治疗毒性和死亡率数据。还使用逻辑回归检查了基线时功能状态、合并症与 SRH 之间的关系。逻辑和 Cox 回归用于检查基线 SRH 与治疗毒性/死亡时间之间的关联。
本研究共纳入 112 名患者(中位年龄 74.1 岁)。基线时,74 名患者(66.1%)SRH 良好,38 名患者(33.9%)SRH 较差。在单变量和多变量分析中,只有合并症数量的增加与基线时的不良 SRH 相关。我们没有发现 SRH 与毒性或死亡率之间存在关联。
相当一部分患者在癌症治疗前和治疗期间的 SRH 较差。合并症数量的增加与基线时的不良 SRH 相关。SRH 不能预测毒性或死亡率。考虑到合并症对该人群 SRH 的影响,应对老年癌症患者的合并症给予关注。