The Prognostic Importance of Frailty in Cancer Survivors.
The Prognostic Importance of Frailty in Cancer Survivors.
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DOI：
10.1111/jgs.13819
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发表时间：
2015-12
影响因子：
6.3
通讯作者：
Harhay MN
中科院分区：
文献类型：
--
作者：
Brown JC;Harhay MO;Harhay MN
量化癌症幸存者人群样本中虚弱前和虚弱的预后重要性。第三次全国健康和营养调查死亡率相关的前瞻性队列研究。美国89个调查地点。基于人群的老年人样本（平均年龄72.2岁），自我报告诊断为非皮肤相关癌症。主要结局为全因死亡率。虚弱的组成部分包括：1）身高体重低; 2）行走缓慢; 3）虚弱; 4）疲惫; 5）体力活动少。符合上述5项标准中1-2项或≥3项的受试者分别被归类为虚弱前期或虚弱。不符合上述任何标准的参与者被认为是非虚弱的。在416名癌症幸存者中，虚弱前和虚弱的患病率分别为37.3%和9.1%。在中位随访11.2年期间，319名（76.7%）参与者死亡。被分类为非虚弱、虚弱前和虚弱的参与者的中位生存期分别为13.9年、9.5年和2.5年。与非虚弱的癌症幸存者相比，被归类为虚弱前[风险比（HR）：1.84（95% CI：1.28-2.65）; P=0.001]或虚弱[HR：2.79（95% CI：1.34-5.81）; P=0.006]的患者过早死亡的风险更高。虚弱前期和虚弱是普遍的临床综合征，可能会增加老年癌症幸存者过早死亡的风险。识别虚弱的癌症幸存者并针对他们进行干预可能是提高癌症后生存率的一种策略。
To quantify the prognostic importance of pre-frailty and frailty among a population-based sample of cancer survivors. The Third National Health and Nutrition Survey mortality-linked prospective cohort study. Eighty-nine survey locations across the United States. Population-based sample of older adults (average age 72.2 years) with a self-reported diagnosis of non-skin-related cancer. The primary outcome was all-cause mortality. Frailty components included: 1) low weight-for-height; 2) slow walking; 3) weakness; 4) exhaustion; and 5) low physical activity. Participants with 1–2 or ≥3 of the 5 above-described criteria were classified as pre-frail or frail, respectively. Participants who did not meet any of the above-described criteria were considered non-frail. Among 416 cancer survivors, the prevalence of pre-frailty and frailty was 37.3% and 9.1%, respectively. During a median follow-up of 11.2-years, 319 (76.7%) participants died. The median survival of participants classified as non-frail, pre-frail, and frail were 13.9-, 9.5-, and 2.5-years, respectively. Compared to non-frail cancer survivors, those classified as pre-frail [Hazard Ratio (HR): 1.84 (95% CI: 1.28–2.65); P=0.001] or frail [HR: 2.79 (95% CI: 1.34–5.81); P=0.006] had a higher risk of premature mortality. Pre-frailty and frailty are prevalent clinical syndromes that may confer an increased risk of premature mortality among older adult cancer survivors. Identifying frail cancer survivors and targeting interventions for them may be a strategy to improve survivorship after cancer.