PDF(Pubmed)
Abstract：
This prospective cohort study aimed to characterise the impact of oxaliplatin-based chemotherapy and its neurotoxic side effects (i.e., chemotherapy-induced neuropathy) on functional fall-risk and falls. Twenty chemotherapy-naïve participants (mean age, 59 years; 16 males) were consecutively included. A multimodal fall risk assessment was performed at four time points within 6 months. Polyneuropathy was assessed using the Neurologic Disability Scale; the fall risk was assessed by functional tests (Tinetti Test, Chair-Rising Test, and Timed up and Go Test). Patient-reported outcomes comprised the Hospitality Anxiety and Depression Scale (HADS), the Falls Efficacy Scale - International (FES-I) to assess the fear of falling, and the Physical Activity for the Elderly (PASE) questionnaire. Three falls occurred during the study. All fallen participants had a high fall risk-index (≥4 more risk factors) compared to only 30% of the non-fallen participants (p = 0.03) and suffered more frequently from pre-existing mild polyneuropathy (p = 0.049). Study discontinuation (n = 12) was associated with a higher rate of polypharmacy (p = 0.045), anxiety (HADS-A, p = 0.03), and specific fear of falling (FES-I, p = 0.025). In contrast, study completers (n = 8) reported an improvement in physical activity (PASE) (p = 0.018). In summary, pre-existing fall-risk factors impacted more falls than chemotherapy. A fall risk index offers a time-efficient screening option in an outpatient oncological setting.
摘要：
这项前瞻性队列研究旨在描述基于奥沙利铂的化疗及其神经毒性副作用的影响(即，化疗引起的神经病)对功能性跌倒风险和跌倒。20名未接受化疗的参与者(平均年龄，59岁；16名男性）被连续包括在内。在6个月内的四个时间点进行多模态跌倒风险评估。使用神经残疾量表评估多发性神经病；通过功能测试评估跌倒风险（TinettiTest，椅子上升测试，并定时并进行测试)。患者报告的结果包括住院焦虑和抑郁量表(HADS)，瀑布功效量表-国际(FES-I)评估对跌倒的恐惧，和老年人身体活动（PASE）问卷。在研究期间发生了三次跌倒。与仅30％的非跌倒参与者（p=0.03）相比，所有跌倒的参与者都有较高的跌倒风险指数（≥4个风险因素），并且更频繁地患有预先存在的轻度多发性神经病（p=0.049）。研究中止（n=12）与较高的多药率相关（p=0.045），焦虑(HADS-A，p=0.03),和特定的跌倒恐惧(FES-I，p=0.025)。相比之下,研究完成者(n=8)报告体力活动(PASE)有所改善(p=0.018).总之,预先存在的跌倒风险因素比化疗对跌倒的影响更大.跌倒风险指数在门诊肿瘤学环境中提供了一种省时的筛查选择。
