老年评估在胃肠道恶性肿瘤患者护理中的整合
Integration of Geriatric Assessment in the Care of Patients with Gastrointestinal Malignancies.
作者信息
Rostoft Siri
机构信息
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
University of Oslo, Oslo, Norway.
出版信息
Visc Med. 2017 Aug;33(4):275-280. doi: 10.1159/000475452. Epub 2017 Aug 3.
BACKGROUND
The majority of patients with gastrointestinal (GI) malignancies are older. Recently, it has become evident that elements from a geriatric assessment (GA) are powerful predictors of outcomes such as postoperative morbidity and mortality, length of stay, type of treatment received, and survival across several GI tumor types in older adults. A GA is a systematic evaluation of functional status, comorbidities, polypharmacy, cognition, nutritional status, emotional status, and social support.
METHODS
A PubMed search was performed in order to identify clinical studies investigating the association between GA and outcomes in patients with GI malignancies.
RESULTS
A total of 31 studies were included in this review. For colorectal cancer, the evidence linking GA variables and frailty to negative outcomes is substantial and consistent. The data regarding other GI malignancies is more limited, but generally shows the same findings.
CONCLUSION
Increasing data shows that elements from a GA and frailty are consistently associated with negative short- and long-term treatment outcomes in older patients with GI malignancies. Future studies should investigate the impact of geriatric interventions on outcomes.
背景
大多数胃肠道（GI）恶性肿瘤患者年龄较大。最近，越来越明显的是，老年评估（GA）中的各项因素是老年患者多种胃肠道肿瘤类型术后发病率和死亡率、住院时间、接受的治疗类型以及生存率等预后的有力预测指标。老年评估是对功能状态、合并症、多重用药、认知、营养状况、情绪状态和社会支持的系统评估。
方法
进行了一项PubMed检索，以确定调查老年评估与胃肠道恶性肿瘤患者预后之间关联的临床研究。
结果
本综述共纳入31项研究。对于结直肠癌，将老年评估变量和虚弱与不良预后联系起来的证据充分且一致。关于其他胃肠道恶性肿瘤的数据较为有限，但总体上显示出相同的结果。
结论
越来越多的数据表明，老年评估中的各项因素和虚弱与老年胃肠道恶性肿瘤患者的短期和长期治疗不良预后始终相关。未来的研究应调查老年干预措施对预后的影响。
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