Performance of Two Geriatric Screening Tools in Older Patients With Cancer
Performance of Two Geriatric Screening Tools in Older Patients With Cancer
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DOI：
10.1200/jco.2013.51.1345
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发表时间：
2014-01-01
影响因子：
45.3
通讯作者：
Wildiers, Hans
中科院分区：
文献类型：
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作者：
Kenis, Cindy;Decoster, Lore;Wildiers, Hans
目的比较两种老年筛查工具(G8和Fremish版本的分诊风险筛查工具[fTRST])的诊断特点，以识别具有老年风险特征的患者，并评估其对功能衰退和总生存期(OS)的预后价值。对所有患者进行G8和fTRST(1)和2[fTRST(2)]的老年筛查，并对社会状况、功能(日常生活活动[ADL]+日常生活工具活动[IADL])、认知、抑郁和营养进行老年评估(GA)。在癌症治疗决定后2-3个月重新评估功能，并追踪死亡率。在两种筛查工具上评估功能下降和OS与正常和异常评分的关系。结果纳入937名患者(2009年10月至2011年7月)。G8和fTRST(1)具有较高的敏感性(86.5%~91.3%)和中等阴性预测值(61.3%~63.4%)。G8和fTRST(1)对ADL和IADL功能下降有较强的预测作用，而G8、fTRST(1)和fTRST(2)对OS有较强的预测作用(P均.001)。G8对OS的预测价值最大(G8正常与异常的风险比为0.38；95%CI为0.27~0.52)。结论G8和fTRST这两种老年筛查工具在老年癌症患者中是一种简单实用的工具，可用于识别有老年风险的患者，并对功能下降和OS有很强的预后价值。
Purpose To compare the diagnostic characteristics of two geriatric screening tools (G8 and Flemish version of the Triage Risk Screening Tool [fTRST]) to identify patients with a geriatric risk profile and to evaluate their prognostic value for functional decline and overall survival (OS).Patients and Methods Patients 70 years old with a malignant tumor were included if a new cancer event occurred requiring treatment decision. Geriatric screening with G8 and fTRST (cutoff 1 [fTRST (1)] and 2 [fTRST (2)] evaluated) was performed in all patients, as well as a geriatric assessment (GA) evaluating social situation, functionality (activities of daily living [ADL] + instrumental activities of daily living [IADL]), cognition, depression, and nutrition. Functionality was re-evaluated 2 to 3 months after cancer treatment decision, and death rate was followed. Functional decline and OS were evaluated in relation to normal versus abnormal score on both screening tools.Results Nine hundred thirty-seven patients were included (October 2009 to July 2011). G8 and fTRST (1) showed high sensitivity (86.5% to 91.3%) and moderate negative predictive value (61.3% to 63.4%) to detect patients with a geriatric risk profile. G8 and fTRST (1) were strongly prognostic for functional decline on ADL and IADL, and G8, fTRST (1), and fTRST (2) were prognostic for OS (all P < .001). G8 had the strongest prognostic value for OS (hazard ratio for G8 normal v abnormal, 0.38; 95% CI, 0.27 to 0.52).Conclusion Both geriatric screening tools, G8 and fTRST, are simple and useful instruments in older patients with cancer for identifying patients with a geriatric risk profile and have a strong prognostic value for functional decline and OS.