The Frailty Index in older women with gynecological cancer
The Frailty Index in older women with gynecological cancer
复制标题
DOI：
10.1007/s40520-020-01473-8
复制
发表时间：
2020-01-24
影响因子：
4
通讯作者：
Cesari, Matteo
中科院分区：
文献类型：
--
作者：
Orlandini, Laura;Nestola, Tiziano;Cesari, Matteo
衰弱是老年肿瘤患者筛查的关键条件。我们工作的目的是测量衰弱指数（FI）在老年妇科癌症妇女队列中1年死亡率的功能和预后价值。方法对200例高龄妇科肿瘤患者（平均年龄73.5岁）进行FI的预后评价。FI是根据Rockwood模型回顾性计算的。Spearman’s rho检验与其他肿瘤量表的相关性：东部肿瘤合作组绩效状态（ECOG）；Karnofsky性能状态（KPS）；脆弱长者量表-13 （vs -13）。采用Cox比例风险模型和ROC曲线评估1年死亡率的预后作用。同时计算敏感性和特异性。结果FI呈正态分布，描述性统计将我们的种群定义为脆弱（平均值= 0.25 +/- 0.11，范围0.08-0.51）。0.7被确认为与生命相容的上限。FI与年龄、ECOG、KPS无显著相关，与vs -13呈正相关（r = 0.7, p < 0.01）。经所有混杂因素校正（OR 3.40; 95% CI 1.55-7.45, p < 0.01）和ROC曲线分析（0.66,95% CI 0.51-0.81, p = 0.01）证实，FI是1年死亡率的最强预测因子。结论衰弱指数是检测老年肿瘤易感性的有效工具，可预测1年死亡率。需要进一步的研究来证实和扩展这些发现。
Introduction Frailty is a key condition to be screened among elderly oncological patients. Aim of our work is to measure the functional and prognostic value for 1-year mortality of the Frailty Index (FI) in a cohort of older women with gynecological cancer. Methods The prognostic value of FI was tested in 200 older women with gynaecological cancer (mean age = 73.5 years). FI was retrospectively calculated following the Rockwood model. Spearman's rho test was used for correlations with other oncological scales: Eastern Cooperative Oncology Group Performance Status (ECOG); Karnofsky Performance Status (KPS); Vulnerable Elders Scale-13 (VES-13). Cox proportional hazard models and ROC curve were performed to estimate prognostic role of 1-year mortality. Sensitivity and specificity were also calculated. Results FI is normally distributed and descriptive statistics define our population as frail (mean = 0.25 +/- 0.11, range 0.08-0.51). 0.7 is confirmed as an upper limit compatible with life. FI does not significantly correlates with age, ECOG and KPS while it positively correlates with VES-13 (r = 0.7, p < 0.01). FI is the strongest predictor for 1-year mortality confirmed after all adjustments for confounders (OR 3.40; 95% CI 1.55-7.45, p < 0.01) and by ROC curve analyses (0.66, 95% CI 0.51-0.81, p = 0.01). Conclusions Frailty Index is a useful tool to detect vulnerability in onco-geriatrics and it predicts 1-year mortality. Further studies are needed to confirm and extend these findings.