METHODS: This multicenter, observational cohort study included 5310 older patients with cancer and 2184 with malnutrition (moderate stage, n = 1023; severe stage, n = 1161). An empirical cumulative distribution curve was performed to illustrate the correlation between malnutrition and QoL. The primary objective was to investigate the association between malnutrition and QoL using logistic regression analysis. Survival analyses were performed to assess the combined prognostic value of malnutrition and QoL.
RESULTS: The median age of the patients (66.9% male, 33.1% female) was 70 years (interquartile range [IQR] 67-74 years) years. The median QoL score was highest in patients without malnutrition (91.88 [IQR 84.44-97.44]), followed by those with moderate (86.15 [IQR 76.18-93.85) and severe (82.31 [IQR 69.87-91.11]) malnutrition. Logistics regression revealed that the risk for developing impaired QoL increased 1.98 (95% confidence interval [CI] 1.64-2.38; P < 0.001) and 2.33 (95% CI 1.93-2.81; P < 0.001) times in patients with moderate and severe malnutrition, respectively. Kaplan-Meier curves showed that QoL in combination with GLIM criteria demonstrated a significant discriminative performance for survival and served as an independent prognostic factor among older patients with cancer, especially for lung and gastric cancers.
CONCLUSIONS: Malnutrition diagnosed according to the GLIM criteria was a predictor of impaired QoL. Additionally, the combination of QoL and malnutrition demonstrated utility for predicting survival outcomes in older patients with cancer.
方法:这个多中心,观察性队列研究包括5310例老年癌症患者和2184例营养不良患者(中度,n=1023;严重阶段,n=1161)。使用经验累积分布曲线来说明营养不良与QoL之间的相关性。主要目的是使用逻辑回归分析研究营养不良与生活质量之间的关系。进行生存分析以评估营养不良和QoL的综合预后价值。
结果:患者的中位年龄(66.9%为男性,33.1%的女性)为70岁(四分位数间距[IQR]67-74岁)。无营养不良患者的QoL评分中位数最高(91.88[IQR84.44-97.44]),其次是中度(86.15[IQR76.18-93.85])和重度(82.31[IQR69.87-91.11])营养不良。后勤回归显示,中度和重度营养不良患者发生QoL受损的风险增加了1.98(95%置信区间[CI]1.64-2.38;P<0.001)和2.33(95%CI1.93-2.81;P<0.001)倍,分别。Kaplan-Meier曲线显示,QoL与GLIM标准结合显示了对生存的显著区分性表现,并作为老年癌症患者的独立预后因素。尤其是肺癌和胃癌。
结论:根据GLIM标准诊断的营养不良是QoL受损的预测因子。此外,QoL和营养不良的组合证明可用于预测老年癌症患者的生存结局.