营养不良与老年胃肠道恶性肿瘤患者老年综合评估损伤及健康相关生活质量的相关性。
Association of malnutrition with geriatric assessment impairments and health-related quality of life among older adults with gastrointestinal malignancies.
机构信息
School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, Alabama.
出版信息
Cancer. 2020 Dec 1;126(23):5147-5155. doi: 10.1002/cncr.33122. Epub 2020 Sep 4.
BACKGROUND
A majority of older adults with cancer develop malnutrition; however, the implications of malnutrition among this vulnerable population are poorly understood. The goal of this study was to quantify the prevalence of nutrition related-symptoms and malnutrition among older adults with gastrointestinal (GI) malignancies and the association of malnutrition with geriatric assessment (GA) impairment, health-related quality of life (HRQoL), and health care utilization.
METHODS
We performed a cross-sectional study of older adults (≥60 years) who were referred to the GI Oncology clinic at the University of Alabama at Birmingham. Participants underwent the Cancer & Aging Resilience Evaluation survey that includes the abbreviated Patient-Generated Subjective Global Assessment of nutrition. Nutrition scores were dichotomized into normal (0-5) and malnourished (≥6), and multivariate analyses adjusted for demographics, cancer type, and cancer stage were used to examine associations with GA impairment, HRQoL, and health care utilization.
RESULTS
A total of 336 participants were included (men, 56.8%; women, 43.2%), with a mean age of 70 years (standard deviation, ±7.2 years) and colorectal cancer (33.6%) and pancreatic cancer (24.4%) being the most common diagnoses. Overall, 52.1% of participants were identified as malnourished. Malnutrition was associated with a higher prevalence of several GA impairments, including 1 or more falls (adjusted odds ratio [aOR], 2.1), instrumental activities of daily living impairment (aOR, 4.1), and frailty (aOR, 8.2). Malnutrition was also associated with impaired HRQoL domains; both physical (aOR, 8.7) and mental (aOR, 5.0), and prior hospitalizations (aOR, 2.2).
CONCLUSION
We found a high prevalence of malnutrition among older adults with GI malignancies that was associated with increased GA impairments, reduced HRQoL, and increased health care utilization.
背景
大多数患有癌症的老年人都会出现营养不良的情况，但对于这一弱势群体来说，营养不良的影响尚未被充分了解。本研究的目的是量化胃肠道（GI）恶性肿瘤老年患者中与营养相关的症状和营养不良的发生率，并研究营养不良与老年综合评估（GA）受损、健康相关生活质量（HRQoL）和医疗保健利用之间的关联。
方法
我们对阿拉巴马大学伯明翰分校 GI 肿瘤学诊所的老年患者（≥60 岁）进行了横断面研究。参与者接受了癌症与衰老弹性评估调查，其中包括简化的患者生成的主观整体营养评估。营养评分分为正常（0-5 分）和营养不良（≥6 分），并使用多变量分析调整了人口统计学、癌症类型和癌症分期，以检查与 GA 受损、HRQoL 和医疗保健利用的关联。
结果
共纳入 336 名参与者（男性占 56.8%，女性占 43.2%），平均年龄为 70 岁（标准差±7.2 岁），最常见的诊断为结直肠癌（33.6%）和胰腺癌（24.4%）。总体而言，52.1%的参与者被认定为营养不良。营养不良与多种 GA 受损的发生率较高有关，包括 1 次或多次跌倒（调整后的优势比[aOR]，2.1）、日常生活活动工具性受损（aOR，4.1）和虚弱（aOR，8.2）。营养不良还与 HRQoL 各领域受损有关，包括身体（aOR，8.7）和心理（aOR，5.0）以及先前住院（aOR，2.2）。
结论
我们发现胃肠道恶性肿瘤老年患者中存在较高的营养不良发生率，这与 GA 受损增加、HRQoL 降低和医疗保健利用增加有关。
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