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患者自评主观全面评定法(PG-SGA)及东部肿瘤协作组(ECOG)体能状态与乳腺癌住院患者的死亡率相关。

The patient generated-subjective global assessment (PG-SGA) and ECOG performance status are associated with mortality in patients hospitalized with breast cancer.

作者信息

da Silva Sandra Helena Kaznowski, de Oliveira Livia Costa, E Silva Lopes Márcia Soares da Mota, Wiegert Emanuelly Varea Maria, Motta Rachel Souza Thompson, Ferreira Peres Wilza Arantes

机构信息

National Cancer Institute (INCA), Rio de Janeiro, RJ, Brazil.

Department of Nutrition and Dietetics, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

出版信息

Clin Nutr ESPEN. 2023 Feb;53:87-92. doi: 10.1016/j.clnesp.2022.11.019. Epub 2022 Nov 30.

Abstract

AIM

This study evaluated the association between risk of malnutrition and performance status, and mortality in hospitalized breast cancer patients.

METHODS

Prospective cohort study with hospitalized breast cancer patients evaluated at a referral Cancer Center. The Risk of malnutrition was assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and performance status was determined using the Eastern Cooperative Oncology Group Performance Status Scale (ECOG PS). Logistic regression was used to analyze the factors associated with death, using the odds ratio (OR) with a 95% confidence interval (CI) as an effect measure.

RESULTS

A total of 195 woman were included, with a mean age of 56.3 (±12.6) years. Patients with an overall PG-SGA score ≥18 (OR: 2.11; 95% CI: 1.03-4.62) and ECOG PS ≥ 3 (OR: 3.34; 95% CI: 1.48-7.52) had a higher occurrence of death during hospitalization, regardless of age or disease stage. The concomitant presence of these two factors improved the accuracy of the association (OR: 5.32; 95% CI: 3.11-9.76) and showed good predictive accuracy (C-statistics: 0.77).

CONCLUSION

Nutritional risk and poor performance status were associated with a higher occurrence of death in women with breast cancer. The use of these two indicators improves their predictive accuracy for mortality.

摘要

目的

本研究评估了住院乳腺癌患者营养不良风险与体能状态及死亡率之间的关联。

方法

对一家转诊癌症中心的住院乳腺癌患者进行前瞻性队列研究。采用患者主观全面评定法(PG-SGA)评估营养不良风险,使用东部肿瘤协作组体能状态量表(ECOG PS)确定体能状态。采用逻辑回归分析与死亡相关的因素,以比值比(OR)及其95%置信区间(CI)作为效应量。

结果

共纳入195名女性,平均年龄为56.3(±12.6)岁。总体PG-SGA评分≥18分的患者(OR:2.11;95%CI:1.03 - 4.62)以及ECOG PS≥3的患者(OR:3.34;95%CI:1.48 - 7.52)在住院期间死亡发生率更高,无论年龄或疾病分期如何。这两个因素同时存在可提高关联的准确性(OR:5.32;95%CI:3.11 - 9.76),并显示出良好的预测准确性(C统计量:0.77)。

结论

营养风险和较差的体能状态与乳腺癌女性患者较高的死亡发生率相关。使用这两个指标可提高其对死亡率的预测准确性。

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