Bhurtyal Kiran K, Tin Amy L, Vickers Andrew J, Shahrokni Armin
Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Support Care Cancer. 2025 Feb 1;33(2):138. doi: 10.1007/s00520-025-09214-1.
Geriatric co-management is associated with a lower postoperative mortality among older adults with cancer. This might be due to a higher use of rehabilitation services such as physical therapy (PT) or occupational therapy (OT). In this study, we assess the relationship between geriatric co-management and PT /OT use.
This is a retrospective cohort study of adults aged 75 years and older with cancer who underwent elective surgery at Memorial Sloan Kettering Cancer Center between February 2015 and February 2018. We used two separate multivariable logistic regression models for PT and OT, adjusted for age at surgery, gender, American Society of Anesthesiology score, preoperative albumin, operative time, and estimated blood loss. We also evaluated the association between frailty and receipt of PT and or OT using separate models by additionally including frailty as a primary predictor.
Of the 1650 patients, 308 (19%) did not receive PT or OT, 747 (45%) received only PT, and 593 (36%) received both PT and OT. Geriatric co-management was significantly associated with higher PT use (OR = 1.58, 95% CI = 1.19, 2.11, p = 0.002) and higher OT use (OR = 1.36, 95% CI = 1.08, 1.71, p = 0.010). The associations between geriatric co-management and rehabilitation service remained after additional adjustment for frailty. Higher degree of frailty was also associated with higher PT use (OR = 1.11, 95% CI = 1.01, 1.22, p = 0.033) and higher OT use (OR = 1.25, 95% CI = 1.15, 1.34, p < 0.0001).
Geriatric co-management and frailty were associated with greater use of PT and OT. Future studies should investigate the impact of geriatric co-management on functional recovery.
老年共同管理与老年癌症患者较低的术后死亡率相关。这可能是由于更多地使用了康复服务，如物理治疗（PT）或职业治疗（OT）。在本研究中，我们评估老年共同管理与PT/OT使用之间的关系。
这是一项对2015年2月至2018年2月期间在纪念斯隆凯特琳癌症中心接受择期手术的75岁及以上成年癌症患者的回顾性队列研究。我们针对PT和OT使用了两个单独的多变量逻辑回归模型，并对手术年龄、性别、美国麻醉医师协会评分、术前白蛋白、手术时间和估计失血量进行了调整。我们还通过在单独的模型中额外纳入虚弱作为主要预测因素，评估了虚弱与接受PT和/或OT之间的关联。
在1650名患者中，308名（19%）未接受PT或OT，747名（45%）仅接受PT，593名（36%）同时接受PT和OT。老年共同管理与更高的PT使用率显著相关（OR = 1.58，95%CI = 1.19，2.11，p = 0.002）和更高的OT使用率（OR = 1.36，95%CI = 1.08，1.71，p = 0.010）。在对虚弱进行额外调整后，老年共同管理与康复服务之间的关联仍然存在。更高程度的虚弱也与更高的PT使用率（OR = 1.11，95%CI = 1.01，1.22，p = 0.033）和更高的OT使用率（OR = 1.25，95%CI = 1.15，1.34，p < 0.0001）相关。
老年共同管理和虚弱与更多地使用PT和OT相关。未来的研究应调查老年共同管理对功能恢复的影响。
