目的:营养不良是一种常见的老年综合征,具有包括死亡率在内的多种阴性结局。然而,很少有文献关注营养不良风险及其对老年综合征和癌症患者死亡率的临床意义之间的关系.这项研究的目的是确定营养不良风险在老年肿瘤学实践中的临床重要性。
方法:180例≥65岁的癌症患者纳入研究。所有患者都接受了老年综合征的询问,包括多药房,脆弱,可能的肌少症,跌倒风险,强直症,抑郁症,认知障碍,失眠,和白天过度嗜睡。迷你营养评估评分>23.5和17-23.5分为营养良好和营养不良风险。分别。
结果:在180名患者中(平均年龄73.0±5.6岁,女性:50%),营养不良风险的患病率为28.9%.各组之间在年龄方面没有统计学上的显著差异,性别,教育,婚姻状况,身体质量指数,除慢性阻塞性肺疾病外的合并症(p>0.05)。调整后的年龄,性别,和体重指数;多重用药(比值比[OR]:3.17;95%置信区间[CI],1.48-6.81),小腿围减少(OR:3.72;95%CI,1.22-11.38),跌倒风险(OR:2.72;95%CI,1.03-7.23),抑郁症(OR:6.24;95%CI,2.75-14.18),失眠(OR:4.89;95%CI,2.16-11.05),与营养良好的患者相比,虚弱(OR:2.44;95%CI,1.75-3.40)与营养不良风险相关(p<0.05)。营养不良风险患者的中位生存期为21.3个月(范围14.1-28.495%CI),未达到营养良好的患者的中位生存期(p<0.001)。
结论:在老年癌症患者中,营养不良的风险与全因死亡的风险更高相关,并与许多老年综合征有关,包括多药房,跌倒风险,脆弱,失眠,和抑郁症。
OBJECTIVE: Malnutrition is a common geriatric syndrome with multiple negative outcomes including mortality. However, there is a scarcity of literature that focuses on the relationship between malnutrition risk and its clinical implications on geriatric syndromes and mortality among cancer patients. The aim of this study is to determine the clinical importance of malnutrition risk in geriatric oncology practice.
METHODS: 180 patients with cancer who were ≥ 65 years were included in the study. All patients were questioned in terms of geriatric syndromes, including polypharmacy, frailty, probable sarcopenia, fall risk, dynapenia, depression, cognitive impairment, insomnia, and excessive daytime sleepiness. Mini Nutritional Assessment scores > 23.5 and 17-23.5 were categorized as well-nourished and malnutrition risk, respectively.
RESULTS: Of the 180 patients (mean age 73.0 ± 5.6 years, female: 50%), the prevalence of malnutrition risk was 28.9%. There was no statistically significant difference between the groups in terms of age, gender, education, marital status, body mass index, and comorbidities except for chronic obstructive pulmonary disease (p > 0.05). After adjustment for age, sex, and body mass index; polypharmacy (odds ratio [OR]: 3.17; 95% confidence interval [CI], 1.48-6.81), reduced calf circumference (OR: 3.72; 95% CI, 1.22-11.38), fall risk (OR: 2.72; 95% CI, 1.03-7.23), depression (OR: 6.24; 95% CI, 2.75-14.18), insomnia (OR: 4.89; 95% CI, 2.16-11.05), and frailty (OR: 2.44; 95% CI, 1.75-3.40) were associated with malnutrition risk compared to well-nourished patients (p < 0.05). Median survival in patients with malnutrition risk was 21.3 months (range 14.1-28.4 95% CI) and median survival in patients who were defined as well nourished was not reached (p < 0.001).
CONCLUSIONS: The risk of malnutrition was associated with a higher risk for all-cause mortality in older patients with cancer, and was associated with many geriatric syndromes, including polypharmacy, fall risk, frailty, insomnia, and depression.