The Added Value of Family Caregivers' Level of Mastery in Predicting Survival of Glioblastoma Patients: A Validation Study.
The Added Value of Family Caregivers' Level of Mastery in Predicting Survival of Glioblastoma Patients: A Validation Study.
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DOI：
10.1097/ncc.0000000000001027
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发表时间：
2022-09-01
期刊：
影响因子：
2.6
通讯作者：
Sherwood PR
中科院分区：
文献类型：
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作者：
Boele FW;Weimer J;Zamanipoor Najafabadi AH;Murray L;Given CW;Given BA;Donovan HS;Drappatz J;Lieberman FS;Sherwood PR
多形性胶质母细胞瘤（GBM）是一种侵袭性脑肿瘤。患者通常依赖家庭照顾者提供身体和情感支持。我们先前证明，诊断后不久测量的护理人员掌握度可预测GBM患者的生存率，并对已知的生存预测因子进行校正（N=88）。验证照顾者掌握程度的贡献，并调查掌握程度相对于其他预测因素的附加值，以预测15个月的生存率。使用了纵向研究（NCT 02058745）收集的数据。对具有已知临床预测因子（患者年龄、Karnofsky体能状态（KPS）、手术类型、O 6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）启动子甲基化状态）的模型进行多变量考克斯回归分析，并添加和不添加护理人员掌握程度以预测死亡率。通过Harrell的C-统计量研究了每个模型在区分15个月时生存机会最低和最高的患者方面的附加值。总共纳入了41对患者。当单独评估临床预测因素时，KPS和患者年龄是死亡率的显著预测因素（风险比[HR]=0.974（95%置信区间[CI]=0.949-1.000）和HR=1.045（95%CI=1.002-1.091））。加上照顾者的掌握程度，这些临床预测因素仍具有统计学意义，掌握程度显示HR=0.843（95%CI=0.755-0.940）。判别值从C=0.641（具有已知临床预测因子的模型）提高到C=0.778（具有掌握度的模型），表明后者是上级的。我们证实，照顾者掌握与GBM患者的生存。将对护理人员的支持和指导纳入标准护理，可能会对护理人员的健康和患者的结局带来好处。
Glioblastoma multiforme (GBM) is an aggressive brain tumor. Patients commonly rely on family caregivers for physical and emotional support. We previously demonstrated that caregiver mastery measured shortly after diagnosis was predictive of GBM patient survival, corrected for known predictors of survival (N=88). To verify the contribution of caregiver mastery, and investigate the added value of mastery over other predictors to predict 15-month survival. Data collected for a longitudinal study (NCT02058745) were used. Multivariable Cox regression analyses were performed for models with known clinical predictors (patient age, Karnofsky Performance Status (KPS), type of surgery, O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status), with and without adding caregiver mastery to predict mortality. The added value of each model in discriminating between patients with the lowest and highest chance of survival at 15 months was investigated through Harrell’s C-statistics. In total, 41 caregiver-patient dyads were included. When evaluating solely clinical predictors, KPS and patient age were significant predictors of mortality (Hazard Ratio [HR]=0.974 (95% Confidence Interval [CI]=0.949–1.000) and HR=1.045 (95%CI=1.002–1.091)), respectively. Adding caregiver mastery, these clinical predictors remained statistically significant and mastery showed a HR=0.843 (95%CI=0.755–0.940). The discriminative value improved from C=0.641 (model with known clinical predictors) to C=0.778 (model with mastery), indicating the latter is superior. We confirm that caregiver mastery is associated with GBM patient survival. Incorporating support and guidance for caregivers into standard care, could lead to benefits for caregiver wellbeing and patient outcomes.
影响因子：
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作者：
Vrettos I;Kamposioras K;Kontodimopoulos N;Pappa E;Georgiadou E;Haritos D;Papadopoulos AA;Niakas D
通讯作者：
Niakas D