老年化疗患者非计划住院的预测
Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy.
作者信息
Feliu Jaime, Espinosa Enrique, Basterretxea Laura, Paredero Irene, Llabrés Elisenda, Jiménez-Munárriz Beatriz, Losada Beatriz, Pinto Alvaro, Custodio Ana Belén, Muñoz María Del Mar, Gómez-Mediavilla Jeniffer, Torregrosa María Dolores, Cruz Patricia, Higuera Oliver, Molina-Garrido María José
机构信息
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain.
Oncology Department, Hospital Universitario de Donostia, 20014 Donostia, Spain.
出版信息
Cancers (Basel). 2021 Mar 22;13(6):1437. doi: 10.3390/cancers13061437.
PURPOSE
To determine the incidence of unplanned hospitalization (UH) and to identify risk factors for UH in elderly patients with cancer who start chemotherapy.
METHODS
In all, 493 patients over 70 years starting new chemotherapy regimens were prospectively included. A pre-chemotherapy geriatric assessment was performed, and tumor and treatment variables were collected. The association between these factors and UH was examined by using multivariable logistic regression. Score points were assigned to each risk factor.
RESULTS
During the first 6 months of treatment, 37% of patients had at least one episode of UH. Risk factors were the use of combination chemotherapy at standard doses, a MAX2 index ≥1, a Charlson comorbidity score ≥2, albumin level <3.5 g/dL, falls in the past 6 months ≥1, and weight loss >5%. Three risk groups for UH were established according to the score in all patients: 0-1: 17.5%; 2: 34%; and 3-7: 57% ( < 0.001). The area under receiver operation characteristic (ROC) curve was 0.72 (95% CI: 0.67-0.77).
CONCLUSION
This simple tool can help to reduce the incidence of UH in elderly patients with cancer who are scheduled to initiate chemotherapy treatment.
目的
确定计划外住院（UH）的发生率，并识别开始化疗的老年癌症患者发生UH的危险因素。
方法
前瞻性纳入493例70岁以上开始新化疗方案的患者。进行化疗前老年评估，并收集肿瘤和治疗变量。使用多变量逻辑回归分析这些因素与UH之间的关联。为每个危险因素分配评分。
结果
在治疗的前6个月内，37%的患者至少有一次UH发作。危险因素包括使用标准剂量的联合化疗、MAX2指数≥1、Charlson合并症评分≥2、白蛋白水平<3.5 g/dL、过去六个月内跌倒≥1次以及体重减轻>5%。根据所有患者的评分建立了三个UH风险组：0-1分：17.5%；2分：34%；3-7分：57%（P<0.001）。受试者操作特征（ROC）曲线下面积为0.72（95%CI：0.67-0.77）。
结论
这个简单的工具有助于降低计划接受化疗的老年癌症患者的UH发生率。
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