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The value of a comprehensive geriatric assessment for patient care in acutely hospitalized older patients with cancer

机译:老年医学综合评估对急性住院老年癌症患者的护理价值

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摘要

A comprehensive geriatric assessment systematically collects information on geriatric conditions and is propagated in oncology as a useful tool when assessing older cancer patients. The objectives were: (a) to study the prevalence of geriatric conditions in cancer patients aged ≥ 65 years, acutely admitted to a general medicine ward; (b) to determine functional decline and mortality within 12 months after admission; and (c) to assess which geriatric conditions and cancer-related variables are associated with 12-month mortality. This was an observational cohort study of 292 cancer patients aged ≥ 65 years, acutely admitted to the general medicine and oncology wards of two university hospitals and one secondary teaching hospital. Baseline assessments included patient characteristics, reason for admission, comorbidity, and geriatric conditions. Follow-up at 3 and 12 months was aimed at functional decline (loss of one or more activities of daily living [ADL]) and mortality. The median patient age was 74.9 years, and 95% lived independently; 126 patients (43%) had metastatic disease. A high prevalence of geriatric conditions was found for instrumental ADL impairment (78%), depressive symptoms (65%), pain (65%), impaired mobility (48%), malnutrition (46%), and ADL impairment (38%). Functional decline was observed in 8% and 33% of patients at 3 and 12 months, respectively. Mortality rates were 38% at 3 months and 64% at 12 months. Mortality was associated with cancer-related factors only. In these acutely hospitalized older cancer patients, mortality was only associated with cancer-related factors. The prevalence of geriatric conditions in this population was high. Future research is needed to elucidate if addressing these conditions can improve quality of life
机译:全面的老年评估系统地收集有关老年病的信息,并在肿瘤学中传播,作为评估老年癌症患者的有用工具。目的是:(a)研究急性进入普通病房的≥65岁癌症患者的老年病患病率; (b)确定入院后12个月内的功能下降和死亡率; (c)评估哪些老年病和与癌症相关的变量与12个月死亡率相关。这是一项观察性队列研究,对292名≥65岁的癌症患者进行了急诊,他们分别被两家大学医院和一家二级教学医院的普通科和肿瘤科收治。基线评估包括患者特征,入院原因,合并症和老年病。在3和12个月时进行随访,旨在降低功能(减少一项或多项日常生活活动[ADL])和死亡率。患者中位年龄为74.9岁,其中95%的人独立生活。 126例患者(43%)患有转移性疾病。老年性疾病的患病率很高,包括工具性ADL障碍(78%),抑郁症状(65%),疼痛(65%),行动不便(48%),营养不良(46%)和ADL障碍(38%) 。在3个月和12个月时,分别有8%和33%的患者观察到功能下降。 3个月时死亡率为38%,12个月时死亡率为64%。死亡率仅与癌症相关因素有关。在这些急性住院的老年癌症患者中,死亡率仅与癌症相关因素有关。该人群中老年人的患病率很高。需要进一步的研究来阐明解决这些状况是否可以改善生活质量

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