A comparison of two pre-operative frailty measures in older surgical cancer patients
A comparison of two pre-operative frailty measures in older surgical cancer patients
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DOI：
10.1016/j.jgo.2011.09.002
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发表时间：
2012-01-01
影响因子：
3
通讯作者：
Wyller, Torgeir B.
中科院分区：
文献类型：
--
作者：
Kristjansson, Sin R.;Ronning, Benedicte;Wyller, Torgeir B.
背景：测量老年癌症患者的虚弱程度可能会识别出治疗并发症风险增加的患者。由于如何识别虚弱仍然存在争议，本研究的目的是在老年结直肠癌患者队列中比较基于综合老年评估（CGA）的术前多领域虚弱测量与虚弱物理表型（PF）的修改版本，并分析两种分类预测术后并发症和生存率的能力。方法：一项前瞻性纵向研究，包括176例年龄70-94岁的患者，在挪威三家医院选择性手术治疗结直肠癌。进行术前CGA、自我报告的生活质量以及握力和步态速度测量。CGA-虚弱被定义为满足以下标准中的一个或多个：日常生活活动的依赖性，严重的合并症，认知功能障碍，抑郁症，营养不良，或> 7天的药物治疗。PF的定义符合以下三个或三个以上标准：意外体重减轻、疲惫、体力活动少、握力受损或步态速度缓慢。结果测量术后并发症和生存率。结果：分类之间的一致性较差。在75例（43%）患者中确定了CGA虚弱，而在22例（13%）患者中确定了PF。只有CGA脆弱预测术后并发症[P=0.001]。这两项措施预测survival.Conclusions：一个多域的脆弱性措施的基础上CGA是更有用的比脆弱性确定从修改后的版本的PF标准在预测术后并发症。对于总生存期，两种虚弱指标均具有预测性。(C)2011爱思唯尔有限公司保留所有权利。
Background: Measuring frailty in older adults with cancer may identify patients with an increased risk of treatment complications. As it remains controversial how to identify frailty, the aim of this study was to compare a pre-operative multi-domain frailty measure based on a comprehensive geriatric assessment (CGA) to a modified version of the physical phenotype of frailty (PF) in a cohort of older adults with colorectal cancer, and to analyze the ability of the two classifications to predict post-operative complications and survival.Methods: A prospective longitudinal study including 176 patients aged 70-94 years electively operated for colorectal cancer in three Norwegian hospitals. A pre-operative CGA, self-reported quality of life, and measurements of grip strength and gait speed were performed. CGA-frailty was defined as fulfilling one or more of the following criteria: dependency in activities of daily living, severe comorbidity, cognitive dysfunction, depression, malnutrition, or >seven daily medications. PF was defined with three or more of the following criteria: unintentional weight loss, exhaustion, low physical activity, impaired grip strength, or slow gait speed. Outcome measures were post-operative complications and survival.Results: The agreement between the classifications was poor. CGA-frailty was identified in 75 (43%) patients, while PF was identified in 22 (13%) patients. Only CGA-frailty predicted post-operative complications [P=0.001]. Both measures predicted survival.Conclusions: A multi-domain frailty measure based on a CGA was more useful than frailty identified from a modified version of the PF criteria in predicting post-operative complications. For overall survival, both frailty measures were predictive. (C) 2011 Elsevier Ltd. All rights reserved.