癌症幸存者中患者报告的与客观测量的身体功能及死亡风险

Patient-reported versus objectively-measured physical function and mortality risk among cancer survivors.

作者信息

Brown Justin C, Harhay Michael O, Harhay Meera N

机构信息

Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, USA.

Division of Nephrology, Department of Medicine, Drexel University College of Medicine, USA.

出版信息

J Geriatr Oncol. 2016 Mar;7(2):108-15. doi: 10.1016/j.jgo.2016.01.009. Epub 2016 Feb 18.

Abstract

OBJECTIVE

This study aimed to characterize the relationship of patient-reported functional limitations, gait speed, and mortality risk among cancer survivors.

MATERIALS AND METHODS

This study included cancer survivors from the Third National Health and Nutrition Survey. Patient-reported functional limitations were quantified by asking participants to assess their ability to complete five tasks: (1) walking 1/4 mi, (2) walking up 10 steps, (3) stooping, crouching, or kneeling, (4) lifting or carrying an object of 10 lb, and (5) standing up from an armless chair. Gait speed was quantified using a 2.4-meter walk. Vital status was obtained through the United States National Center for Health Statistics.

RESULTS

The study sample included 428 cancer survivors who averaged 72.1 years of age. The average number of patient-reported functional limitations was 1.8 (out of 5) and 66% of participants reported ≥1 functional limitation. Patient-reported functional limitations and gait speed were related, such that each functional limitation associated with a -0.08m/s slower gait speed (95% confidence interval: -0.10 to -0.06; P<0.001). During a median follow-up of 11years, 329 (77%) participants died. In multivariable-adjusted analysis, patient-reported functional limitations and survival were related, such that each additional reported functional limitation was associated with a 19% increase in the risk of death (95% confidence interval: 9% to 29%; P<0.001).

CONCLUSION

Patient-reported functional limitations are prevalent among cancer survivors, and associate with slower gait speeds and shorter survival. These data may provide increased insight on long-term prognosis and inform clinical decision-making by identifying subgroups of cancer survivors who may benefit from rehabilitative intervention.

摘要

目的

本研究旨在描述癌症幸存者中患者报告的功能受限、步速和死亡风险之间的关系。

材料与方法

本研究纳入了第三次全国健康与营养调查中的癌症幸存者。通过要求参与者评估其完成五项任务的能力来量化患者报告的功能受限情况:(1)步行1/4英里;(2)上10级台阶;(3)弯腰、蹲伏或跪;(4)提起或搬运10磅的物体;(5)从无扶手椅子上站起来。使用2.4米步行来量化步速。通过美国国家卫生统计中心获取生命状态信息。

结果

研究样本包括428名平均年龄为72.1岁的癌症幸存者。患者报告的功能受限平均数量为1.8项(满分5项),66%的参与者报告有≥1项功能受限。患者报告的功能受限与步速相关,每一项功能受限与步速减慢0.08m/s相关(95%置信区间:-0.10至-0.06;P<0.001)。在中位随访11年期间,329名(77%)参与者死亡。在多变量调整分析中,患者报告的功能受限与生存相关,每增加一项报告的功能受限与死亡风险增加19%相关(95%置信区间:9%至29%;P<0.001)。

结论

患者报告的功能受限在癌症幸存者中普遍存在,并与较慢的步速和较短的生存期相关。这些数据可能有助于更深入了解长期预后,并通过识别可能从康复干预中受益的癌症幸存者亚组为临床决策提供参考。

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