School of Nursing, University of California, San Francisco, California, USA.
School of Medicine, University of California, San Francisco, California, USA.
J Pain Symptom Manage. 2017 Sep;54(3):263-272. doi: 10.1016/j.jpainsymman.2017.07.018. Epub 2017 Jul 15.
Although physical function is an important patient outcome, little is known about changes in physical function in older adults receiving chemotherapy (CTX).
Identify subgroups of older patients based on changes in their level of physical function; determine which demographic and clinical characteristics were associated with subgroup membership; and determine if these subgroups differed on quality-of-life (QOL) outcomes.
Latent profile analysis was used to identify groups of older oncology patients (n = 363) with distinct physical function profiles. Patients were assessed six times over two cycles of CTX using the Physical Component Summary score from the Short Form 12. Differences, among the groups, in demographic and clinical characteristics and QOL outcomes were evaluated using parametric and nonparametric tests.
Three groups of older oncology patients with distinct functional profiles were identified: Well Below (20.4%), Below (43.8%), and Above (35.8%) normative Physical Component Summary scores. Characteristics associated with membership in the Well Below class included the following: lower annual income, a higher level of comorbidity, being diagnosed with depression and back pain, and lack of regular exercise. Compared with the Above class, patients in the other two classes had significantly poorer QOL outcomes.
Almost 65% of older oncology patients reported significant decrements in physical function that persisted over two cycles of CTX. Clinicians can assess for those characteristics associated with poorer functional status to identify high-risk patients and initiate appropriate interventions.
尽管身体机能是重要的患者预后指标，但对于接受化疗（CTX）的老年患者身体机能的变化知之甚少。
根据身体机能水平的变化，确定老年患者的亚组；确定与亚组成员身份相关的人口统计学和临床特征；并确定这些亚组在生活质量（QOL）结果上是否存在差异。
使用潜在剖面分析确定具有不同身体机能特征的老年肿瘤患者（n=363）亚组。使用 12 项简短表格的身体成分综合评分，在 CTX 的两个周期内，对患者进行六次评估。使用参数和非参数检验评估不同亚组在人口统计学和临床特征以及 QOL 结果方面的差异。
确定了具有不同功能特征的三组老年肿瘤患者：明显低于（20.4%）、低于（43.8%）和高于（35.8%）正常的身体成分综合评分。与 Well Below 类别的成员身份相关的特征包括：较低的年收入、更高的合并症水平、被诊断患有抑郁症和背痛，以及缺乏规律运动。与 Above 类别的患者相比，其他两个类别的患者的 QOL 结果明显较差。
近 65%的老年肿瘤患者报告身体机能显著下降，这种情况在两个 CTX 周期中持续存在。临床医生可以评估与较差功能状态相关的特征，以识别高风险患者并采取适当的干预措施。
