Velghe Anja, Petrovic Mirko, De Buyser Stefanie, Demuynck Rein, Noens Lucien
Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
Department of Haematology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
Eur J Oncol Nurs. 2014 Dec;18(6):645-8. doi: 10.1016/j.ejon.2014.05.006. Epub 2014 Jun 20.
Incidence rates of haematological malignancies increase with age. In these older cancer patients, important information may be missed without a Comprehensive Geriatric Assessment (CGA). A validated screening instrument is needed to identify those patients for whom a CGA would be beneficial. The G8 has recently been validated as a screening tool for older cancer patients in need of a CGA.
To test the performance of the G8 screening tool in older patients with aggressive haematological malignancies to identify those who would benefit from a CGA.
Cross-sectional study of patients ≥70 years with a recently diagnosed haematological malignancy. G8, CGA (including six questionnaires) and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) were completed in each patient. The CGA was considered abnormal when at least one questionnaire showed an impaired score.
Fifty patients with median age of 76 years were included; 88% (N = 44) had an abnormal CGA. ROC curve analyses revealed a G8 score ≤14 obtained a sensitivity of 89% (95% CI 75-96) and a specificity of 100% (95% CI 54-100), suggesting an optimal cut-off point. AUC ± SE was 0.949 ± 0.030. Inclusion of comorbidity in the CGA did not change the performance of the G8 (0.943 ± 0.034; P = 0.895).
The G8 can be used as a valid screening tool in older patients with aggressive haematological malignancies to identify those patients who would benefit from a CGA. Comorbidity should be assessed routinely and independently of the G8.
血液系统恶性肿瘤的发病率随年龄增长而增加。在这些老年癌症患者中,如果没有进行综合老年评估(CGA),可能会遗漏重要信息。需要一种经过验证的筛查工具来识别那些能从CGA中获益的患者。G8最近已被验证为一种针对需要CGA的老年癌症患者的筛查工具。
测试G8筛查工具在老年侵袭性血液系统恶性肿瘤患者中的性能,以识别那些能从CGA中获益的患者。
对年龄≥70岁且最近诊断为血液系统恶性肿瘤的患者进行横断面研究。每位患者均完成G8、CGA(包括六份问卷)和老年累积疾病评定量表(CIRS-G)。当至少一份问卷显示评分受损时,CGA被认为异常。
纳入50例患者,中位年龄76岁;88%(N = 44)的患者CGA异常。ROC曲线分析显示,G8评分≤14时,灵敏度为89%(95%CI 75-96),特异度为100%(95%CI 54-100),提示这是一个最佳切点。AUC±SE为0.949±0.030。在CGA中纳入合并症并未改变G8的性能(0.943±0.034;P = 0.895)。
G8可作为老年侵袭性血液系统恶性肿瘤患者的有效筛查工具,以识别那些能从CGA中获益的患者。应常规且独立于G8对合并症进行评估。