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有或无活动性癌症的老年住院患者的住院病程比较:一项双中心病例对照研究。

Comparison of hospital course of geriatric inpatients with or without active cancer: a bicentric case-control study.

作者信息

Morio Julie, de Decker Laure, Paré Pierre-Yves, Launay Cyrille P, Beauchet Olivier, Annweiler Cédric

机构信息

Service de médecine aiguë gériatrique, Centre hospitalier, Le Mans, France.

Service de médecine aiguë gériatrique, Centre hospitalier universitaire, Nantes, France.

出版信息

Geriatr Psychol Neuropsychiatr Vieil. 2018 Sep 1;16(3):241-246. doi: 10.1684/pnv.2018.0741.

Abstract

BACKGROUND

The hospital course of older patients with cancer hospitalized in geriatrics units remain poorly known. The aim of our study was to compare the clinical characteristics and hospital courses of geriatric inpatients with or without active cancer.

METHODS

A case-control study was conducted in 2013 in the geriatric acute care units of Angers University Hospital and Le Mans Hospital, France, to compare 204 consecutive cases with cancer (mean age, 85.4±5.5 years; 42.6% male) and 1,020 controls without active cancer (mean age, 85.5±5.8 years; 42.6% male) matched for age, gender, recruitment period and center. Hospital courses were evaluated by the length of hospital stay and the in-hospital mortality. The place of life, body mass index, cumulative illness rating scale-geriatrics (CIRS-G) score, history of falls, and reason for admission were used as covariates.

RESULTS

Cases with active cancer exhibited a higher (i.e., worse) CIRS-G score (p<0.001) and were hospitalized more often for an organic failure (p<0.001) than controls. The hospital stay of cases was longer (16.3±13.0 days versus 12.6±9.4 days, p<0.001), and their in-hospital mortality rate was higher than controls (23.5% versus 5.6%, p<0.001). After adjustment, having an active cancer was associated with increased length of hospital stay (β=3.3, p<0.001) and greater in-hospital mortality (OR=4.4, p<0.001).

CONCLUSION

The length of hospital stay and in-hospital mortality rate were greater in geriatric patients with active cancer compared to controls, which reflects more complicated hospital courses in this population.

摘要

背景

老年癌症患者在老年病科的住院病程仍鲜为人知。我们研究的目的是比较有或无活动性癌症的老年住院患者的临床特征和住院病程。

方法

2013年在法国昂热大学医院和勒芒医院的老年急性护理病房进行了一项病例对照研究,以比较204例连续的癌症病例(平均年龄85.4±5.5岁;男性占42.6%)和1020例无活动性癌症的对照者(平均年龄85.5±5.8岁;男性占42.6%),这些对照者在年龄、性别、招募时期和中心方面进行了匹配。通过住院时间和院内死亡率评估住院病程。将生活地点、体重指数、老年累积疾病评分量表(CIRS-G)得分、跌倒史和入院原因用作协变量。

结果

与对照者相比,活动性癌症病例的CIRS-G得分更高(即更差)(p<0.001),因器官功能衰竭住院的频率更高(p<0.001)。病例的住院时间更长(16.3±13.0天对12.6±9.4天,p<0.001),其院内死亡率高于对照者(23.5%对5.6%,p<0.001)。调整后发现,患有活动性癌症与住院时间延长(β=3.3,p<0.001)和更高的院内死亡率(OR=4.4,p<0.001)相关。

结论

与对照者相比,患有活动性癌症的老年患者住院时间更长,院内死亡率更高,这反映了该人群更复杂的住院病程。

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