Examination of individual and multiple comorbid conditions and health-related quality of life in older cancer survivors.
Examination of individual and multiple comorbid conditions and health-related quality of life in older cancer survivors.
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DOI：
10.1007/s11136-020-02713-0
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Jensen RE
中科院分区：
文献类型：
--
作者：
Siembida EJ;Smith AW;Potosky AL;Graves KD;Jensen RE
老年癌症幸存者（诊断时≥ 65岁）是多发病（2+共病）的高风险人群。然而，很少有研究利用老年癌症幸存者的可推广样本来了解个体共病状况与健康相关生活质量（HRQOL）之间的关系。我们检查了HRQOL结果（疼痛，疲劳，身体功能），个体合并症（心血管疾病[CVD]，肺部疾病，糖尿病，关节炎）和总合并症（仅癌症，癌症+1种疾病，癌症+2种或更多种疾病）之间的相关性。 利用2019年老年癌症幸存者的基于人群的样本，我们使用广义线性模型测试了合并症与HRQOL结局之间的关联。使用患者报告结局测量信息系统®（PROMIS®）测量评估HRQOL领域。科摩罗通过自我报告进行评估。与没有任何疾病的幸存者相比，患有肺部疾病的癌症幸存者报告的身体功能显著更差（β =-4.96，p <0.001），患有关节炎的幸存者报告的疼痛显著更高（β = 4.37，p <0.001），患有CVD的幸存者报告的疲劳显著更高（β = 3.45，p <0.001）。癌症+1条件与所有结果的相关性不像测试个体条件时那样强（例如疼痛：β = 3.09，p <0.001）。有2+合并症与所有结局的相关性（例如身体功能：β =-7.51，p <0.001）比单独检查疾病更强。了解老年癌症幸存者的特定共病状况可以深入了解可能损害癌症生存率的特定HRQOL结局，但了解总的共病负担，无论具体情况如何，都可以揭示HRQOL多重损害风险的幸存者。这些信息结合在一起，可以为风险分层生存护理提供信息。 本文的在线版本（10.1007/s11136 - 020 - 02713 - 0）包含补充材料，可供授权用户使用。
Older cancer survivors (≥ 65 years at diagnosis) are at high-risk for multimorbidity (2 + comorbid conditions). However, few studies have utilized a generalizable sample of older cancer survivors to understand how individual comorbid conditions, as opposed to total comorbidity burden, are associated with health-related quality of life (HRQOL). We examined associations between HRQOL outcomes (pain, fatigue, physical function), individual comorbidities (cardiovascular disease [CVD], lung disease, diabetes, arthritis) and total comorbidity (cancer-only, cancer + 1 condition, cancer + 2 or more conditions). Utilizing a population-based sample of 2019 older cancer survivors, we tested associations between comorbid conditions and the HRQOL outcomes using generalized linear models. HRQOL domains were assessed using Patient-Reported Outcome Measurement Information System® (PROMIS®) measures. Comorbidity was assessed via self-report. Cancer survivors with lung disease reported significantly worse physical functioning (β = − 4.96, p < 0.001), survivors with arthritis reported significantly higher pain (β = 4.37, p < 0.001), and survivors with CVD reported significantly higher fatigue (β = 3.45, p < 0.001) compared to survivors without each condition. Having cancer + 1 condition was not as strongly associated with all outcomes as when individual conditions were tested (e.g. pain: β = 3.09, p < 0.001). Having 2+ comorbidities had a stronger association with all outcomes (e.g. physical function: β = − 7.51, p < 0.001) than examining conditions individually. Knowing the specific comorbid condition profile of an older cancer survivor provides insight into specific HRQOL outcomes that may be impaired in cancer survivorship, but understanding total comorbidity burden, regardless of the specific conditions, sheds light on survivors at-risk for multiple impairments in HRQOL. This information, taken together, can inform risk-stratified survivorship care. The online version of this article (10.1007/s11136-020-02713-0) contains supplementary material, which is available to authorized users.
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