台湾癌症患者中两种虚弱筛查工具的表现。
Performance of two frailty screening tools among patients with cancer in Taiwan.
机构信息
School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Hematology-Oncology and Cancer Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
出版信息
Biomed J. 2022 Apr;45(2):361-369. doi: 10.1016/j.bj.2021.03.002. Epub 2021 Mar 10.
BACKGROUND
Comprehensive Geriatric Assessment (CGA) is the gold standard for detecting frailty in elderly patients with cancer. Since CGA is time- and resource-consuming, many alternative frailty screening tools have been developed; however, it remains unknown whether these tools are suitable for older and adult patients with cancer. Therefore, we used the data collected for a large longitudinal study to compare the diagnostic performances of two frailty screening tools (Geriatric 8 [G8] and Flemish version of the Triage Risk Screening Tool [fTRST]) to identify frailty risk profile among patients with cancer.
METHODS
Patients aged ≥20 years with newly diagnosed cancer were enrolled. Frailty screening with G8, fTRST, and CGA were performed before anti-cancer treatment. Diagnostic characteristics obtained using G8 and fTRST were analyzed by C-index, and the validity of G8 and fTRST was also determined.
RESULTS
40.9% of the 755 patients with cancer displayed frailty on CGA. Both G8 and fTRST showed high sensitivity (80.6-88.4%) and negative predictive value (81.0-81.2%). The C-index of G8 was higher than that of fTRST (0.77 vs 0.71, p = .01). Moreover, the best G8 and fTRST cut-off points were ≤13 and ≥ 2, respectively. The validities of G8 and fTRST were also confirmed; however, frailty age differences were not observed in our study.
CONCLUSION
Frailty is a common problem for patients with cancer, and routine frailty screening is essential for both older and adult patients. G8 and fTRST are simple and useful frailty screening tools, while G8 is more suitable than fTRST for Taiwanese patients with cancer.
背景
全面老年评估（CGA）是检测老年癌症患者虚弱的金标准。由于 CGA 耗时且资源密集，因此已经开发了许多替代的虚弱筛选工具；然而，尚不清楚这些工具是否适用于患有癌症的老年和成年患者。因此，我们使用为一项大型纵向研究收集的数据来比较两种虚弱筛选工具（老年 8 项评分[G8]和 Flemish 版分诊风险筛选工具[fTRST]）的诊断性能，以确定癌症患者的虚弱风险特征。
方法
招募了年龄≥20 岁且新诊断患有癌症的患者。在进行抗癌治疗之前，对 G8、fTRST 和 CGA 进行了虚弱筛查。通过 C 指数分析了使用 G8 和 fTRST 获得的诊断特征，并确定了 G8 和 fTRST 的有效性。
结果
755 例癌症患者中有 40.9%在 CGA 上表现出虚弱。G8 和 fTRST 的灵敏度均较高（80.6%-88.4%），阴性预测值均较高（81.0%-81.2%）。G8 的 C 指数高于 fTRST（0.77 比 0.71，p=0.01）。此外，最佳 G8 和 fTRST 截断值分别为≤13 和≥2。G8 和 fTRST 的有效性也得到了确认；然而，在我们的研究中没有观察到虚弱的年龄差异。
结论
虚弱是癌症患者的常见问题，对老年和成年患者进行常规虚弱筛查至关重要。G8 和 fTRST 是简单且有用的虚弱筛选工具，而 G8 比 fTRST 更适合台湾的癌症患者。
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