Abstract:
A prospective observational study was conducted in a cohort of older adults ≥65 years (n = 329), admitted to the acute medical unit (AMU) of a tertiary hospital, to describe and compare characteristics including frailty status and clinical outcomes. Multivariable models compared older adults with and without a history of cancer to determine characteristics associated with frailty and pre-frailty. An adjusted Poisson regression model was used to compare the length of hospital stay (LOS) between the two groups. About one-fifth (22%) of the cohort had a history of cancer. The most common cancer types were prostate (n = 20), breast (n = 13), lung (n = 8) and gastrointestinal (n = 8). There was no difference in the prevalence of pre-frailty/frailty among patients with or without a history of cancer (58% vs. 57%, p > 0.05). Pre-frailty/frailty was associated with polypharmacy (OR 8.26, 95% CI: 1.74 to 39.2) and malnutrition (OR 8.91, 95% CI: 2.15 to 36.9) in patients with a history of cancer. Adjusted analysis revealed that the risk of having a longer LOS was 24% higher in older adults with a history of cancer than those without (IRR 1.24, 95% CI 1.10 to 1.41, p < 0.001). Clinicians in the AMU should be aware that older adults with a history of cancer have a higher risk of a longer LOS compared to those without.
摘要:
在65岁以上的老年人队列中进行了一项前瞻性观察研究(n=329),入住三级医院的急性医疗单位(AMU),描述和比较特征,包括虚弱状态和临床结局。多变量模型比较了有和没有癌症史的老年人,以确定与虚弱和虚弱前期相关的特征。使用调整的Poisson回归模型比较两组之间的住院时间(LOS)。大约五分之一(22%)的队列有癌症史。最常见的癌症类型是前列腺(n=20),乳房(n=13),肺(n=8)和胃肠道(n=8)。在有或没有癌症病史的患者中,衰弱前/衰弱的患病率没有差异(58%vs.57%,p>0.05)。在有癌症病史的患者中,虚弱/虚弱与多重用药(OR8.26,95%CI:1.74至39.2)和营养不良(OR8.91,95%CI:2.15至36.9)相关。调整后的分析显示,有癌症病史的老年人比没有癌症病史的老年人长LOS的风险高24%(IRR1.24,95%CI1.10至1.41,p<0.001)。AMU的临床医生应该意识到,与没有癌症史的老年人相比,有较长的LOS的风险更高。