Beaudart Charlotte, Drost Ruben M W A, Evers Silvia M A A, Paulus Aggie T G, Hiligsmann Mickaël
Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Cancer Treat Res Commun. 2022;33:100633. doi: 10.1016/j.ctarc.2022.100633. Epub 2022 Sep 9.
To review published scientific evidence evaluating the potential associations between muscle mass/strength and healthcare use/costs for patients with cancer.
In accordance with the predefined protocol for a systematic literature review, studies assessing potential associations between muscle mass/strength and healthcare costs/use in cancer patients were searched on MEDLINE (via Ovid) and on the NHS Economic Evaluation Database in September 2021. Study selection, data extraction and quality assessment were performed by two independent reviewers.
Of 613 studies identified, five met our inclusion criteria. Various outcomes were investigated: for length of hospital stay, one out of three studies reported an association between lower muscle mass and longer hospital stay; for hospital admission, the two identified studies did not highlight muscle weakness as a predictor of hospital admission; for hospital readmission, one out of two studies reported that patients with lower muscle mass had higher rates of hospital readmission; for costs and cost-effectiveness, results of two randomized controlled trials were mixed, with total costs of the intervention higher in one study and lower in the other, leading to opposite cost-effectiveness results.
Only five studies evaluating potential associations between mass/strength and healthcare use/costs have been highlighted within this systematic review. The amount of evidence is limited but the studies are also very heterogeneous in regards of study designs, sample size, and type of population included. This important heterogeneity prevents drawing strong conclusions. Because of limited data available, more high quality longitudinal studies are needed to further investigate the relationship between muscle mass/strength and healthcare costs/use.
回顾已发表的科学证据,评估癌症患者肌肉质量/力量与医疗保健使用/成本之间的潜在关联。
按照系统文献综述的预定义方案,于2021年9月在MEDLINE(通过Ovid)和英国国家医疗服务体系经济评估数据库中检索评估癌症患者肌肉质量/力量与医疗成本/使用之间潜在关联的研究。由两名独立评审员进行研究选择、数据提取和质量评估。
在613项已识别的研究中,有5项符合我们的纳入标准。研究调查了各种结果:关于住院时间,三项研究中有一项报告称肌肉质量较低与住院时间较长之间存在关联;关于住院情况,两项已识别的研究未将肌肉无力作为住院的预测因素;关于再次入院,两项研究中有一项报告称肌肉质量较低的患者再次入院率较高;关于成本和成本效益,两项随机对照试验的结果不一,一项研究中干预措施的总成本较高,另一项研究中则较低,导致成本效益结果相反。
在本系统综述中,仅突出了五项评估质量/力量与医疗保健使用/成本之间潜在关联的研究。证据数量有限,而且这些研究在研究设计、样本量和纳入人群类型方面也非常异质。这种重要的异质性妨碍得出强有力的结论。由于可用数据有限,需要更多高质量的纵向研究来进一步调查肌肉质量/力量与医疗成本/使用之间的关系。