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老年癌症患者的非计划性住院:发生率和预测因素。

Unplanned hospitalizations in older patients with cancer: Occurrence and predictive factors.

机构信息

Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.

出版信息

J Geriatr Oncol. 2021 Apr;12(3):368-374. doi: 10.1016/j.jgo.2020.11.004. Epub 2020 Nov 19.

Abstract

BACKGROUND

This study aims to investigate the occurrence of unplanned hospitalizations in older patients with cancer and to determine predictive factors.

METHODS

A prospective Belgian multicentre (n = 22), observational cohort study was performed. Patients ≥70 years with a malignant tumor were included. Patients underwent G8 screening followed by geriatric assessment (GA) if abnormal at baseline and were followed for unplanned hospitalizations at approximately three months. Uni- and multivariable regression models were performed to determine predictive factors associated with unplanned hospitalizations in older patients with an abnormal G8.

RESULTS

In total, 7763 patients were included in the current analysis of which 2409 (31%) patients with a normal G8 score and 5354 (69%) with an abnormal G8 score. Patients with an abnormal G8 were hospitalized more frequently than patients with a normal G8 (22.9% versus 12.4%; p < 0.0001). Reasons for unplanned hospitalizations were most frequently cancer related (25.7%) or cancer therapy related (28%). In multivariable analysis, predictive factors for unplanned hospitalizations in older patients with cancer and an abnormal G8 were female gender, absence of surgery, chemotherapy, ADL dependency, malnutrition and presence of comorbidities.

CONCLUSION

Older patients with cancer and an abnormal G8 screening present a higher risk (23%) for unplanned hospitalizations. Predictive factors for these patients were identified and include not only patient and treatment related factors but also GA related factors.

摘要

背景

本研究旨在调查老年癌症患者中非计划性住院的发生情况,并确定预测因素。

方法

进行了一项前瞻性的比利时多中心(n=22)观察性队列研究。纳入年龄≥70 岁且患有恶性肿瘤的患者。患者接受 G8 筛查,如果基线时异常,则进行老年评估(GA),并在大约三个月时进行非计划性住院随访。采用单变量和多变量回归模型来确定与异常 G8 的老年患者非计划性住院相关的预测因素。

结果

共纳入 7763 例患者进行当前分析,其中 2409 例(31%)患者 G8 评分正常,5354 例(69%)患者 G8 评分异常。G8 异常的患者住院频率高于 G8 正常的患者(22.9%对 12.4%;p<0.0001)。非计划性住院的原因主要与癌症相关(25.7%)或与癌症治疗相关(28%)。多变量分析显示,G8 异常的老年癌症患者非计划性住院的预测因素为女性、无手术、化疗、ADL 依赖、营养不良和合并症。

结论

G8 筛查异常的老年癌症患者非计划性住院的风险较高(23%)。这些患者的预测因素不仅包括患者和治疗相关因素,还包括 GA 相关因素。

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