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更好地了解实体瘤老年患者以改善管理的愿望:评估与指导性干预——法国普罗旺斯-阿尔卑斯-蓝色海岸大区队列研究经验

The Desire to Better Understand Older Adults with Solid Tumors to Improve Management: Assessment and Guided Interventions-The French PACA EST Cohort Experience.

作者信息

Boulahssass Rabia, Gonfrier Sebastien, Champigny Noémie, Lassalle Sandra, François Eric, Hofman Paul, Guerin Olivier

机构信息

Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de Nice, 06000 Nice, France.

FHU OncoAge, Nice 06000, France.

出版信息

Cancers (Basel). 2019 Feb 7;11(2):192. doi: 10.3390/cancers11020192.

DOI:10.3390/cancers11020192
PMID:30736406
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6406576/
Abstract

Todays challenge in geriatric oncology is to screen patients who need geriatric follow-up. The main goal of this study was to analyze factors that identify patients, in a large cohort of patients with solid tumors, who need more geriatric interventions and therefore specific follow-up. Between April 2012 and May 2018, 3530 consecutive patients were enrolled in the PACA EST cohort (France). A total of 3140 patients were finally enrolled in the study. A Comprehensive Geriatric Assessment (CGA) was performed at baseline. We analyzed the associations between factors at baseline (geriatric and oncologic factors) and the need to perform more than three geriatric interventions. The mean age of the population was 82 years old with 59% of patients aged older than 80 years old. A total of 8819 geriatric interventions were implemented for the 3140 patients. The percentage of patients with three or more geriatric interventions represented 31.8% (n = 999) of the population. In multivariate analyses, a Mini Nutritional assessment (MNA) <17, an MNA ≤23·5 and ≥17, a performans status (PS) >2, a dependence on Instrumental Activities of Daily Living (IADL), a Geriatric Depression Scale (GDS) ≥5, a Mini Mental State Examination (MMSE) <24, and a Screening tool G8 ≤14 were independent risk factors associated with more geriatric interventions. Factors associated with more geriatric interventions could assist practitioners in selecting patients for specific geriatric follow-up.

摘要

如今老年肿瘤学面临的挑战是筛选出需要老年医学随访的患者。本研究的主要目的是分析在一大群实体瘤患者中,能够识别出那些需要更多老年医学干预措施从而需要特定随访的患者的因素。在2012年4月至2018年5月期间,连续3530例患者纳入了PACA EST队列研究(法国)。最终共有3140例患者纳入本研究。在基线时进行了全面老年医学评估(CGA)。我们分析了基线因素(老年医学和肿瘤学因素)与进行超过三次老年医学干预需求之间的关联。研究人群的平均年龄为82岁,59%的患者年龄超过80岁。对3140例患者共实施了8819次老年医学干预。接受三次或更多次老年医学干预的患者占总人群的31.8%(n = 999)。在多因素分析中,微型营养评定量表(MNA)<17、MNA≤23.5且≥17、体能状态(PS)>2、对工具性日常生活活动(IADL)存在依赖、老年抑郁量表(GDS)≥5、简易精神状态检查表(MMSE)<24以及筛查工具G8≤14是与更多老年医学干预相关的独立危险因素。与更多老年医学干预相关的因素可帮助医生选择需要特定老年医学随访的患者。

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