Impact of Preoperative Social Frailty on Overall Survival and Cancer-Specific Survival among Older Patients with Gastrointestinal Cancer

被引：13

作者：

Ono, Rei ^{[1
]}

Makiura, Daisuke ^{[2
]}

Nakamura, Tetsu ^{[3
]}

Okumura, Maho ^{[2
]}

Fukuta, Akimasa ^{[4
]}

Saito, Takashi ^{[1
,2
]}

Inoue, Junichiro ^{[2
]}

Oshikiri, Taro ^{[3
]}

Kakeji, Yoshihiro ^{[3
]}

Sakai, Yoshitada ^{[2
,5
]}

机构：

[1] Kobe Univ, Dept Publ Hlth, Grad Sch Hlth Sci, Kobe, Hyogo, Japan

[2] Kobe Univ Hosp, Div Rehabil, Kobe, Hyogo, Japan

[3] Kobe Univ, Dept Surg, Div Gastrointestinal Surg, Grad Sch Med, Kobe, Hyogo, Japan

[4] Nagoya Univ Hosp, Div Rehabil, Nagoya, Aichi, Japan

[5] Kobe Univ, Div Rehabil Med, Grad Sch Med, Kobe, Hyogo, Japan

来源：

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | 2021年 / 22卷 / 09期

基金：

日本学术振兴会;

关键词：

Social frailty; Geriatric; 8; overall survival; older patients; gastrointestinal cancer; GERIATRIC ASSESSMENT; INTERNATIONAL-SOCIETY; DEPRESSION SCALE; SCREENING TOOLS; RISK; COMPLICATIONS; CONSENSUS; ADULTS;

D O I：

10.1016/j.jamda.2021.03.025

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objectives: Frailty is a multidimensional syndrome. However, typical frailty scales used in oncology clinics assess physical impairment and/or malnutrition but do not consider the social domain. Our study aimed to clarify the relationship between preoperative social frailty and overall survival (OS) and cancer-specific survival (CSS) among older patients with gastrointestinal cancer. Design: This was a prospective cohort study. Setting and Participants: This single-center study recruited 195 patients with gastrointestinal cancer scheduled for curative surgery and aged >60 years. Methods: The outcomes considered were the OS and CSS of surgery. Primary associated factors included frailty defined as a Geriatric 8 score <14; social frailty defined as 2 or more of the followingdgoing out less frequently, rarely visiting friends, feeling unhelpful to friends or family, living alone, and not talking with someone daily, and combinations therein [no frailty without social frailty (-/-), frailty without social frailty (+/-), no frailty with social frailty (-/+), and frailty with social frailty (+/+)]. We used the Cox proportional hazards model and the Fine and Gray proportional subdistribution hazard model adjusting for confounding factors. Results: Of the 195 patients, 181 (mean age, 72.0 years) were included for analysis. The median follow-up time was 994 days. Social frailty (hazard ratio 3.10) and their combinations [6.35; frailty with social frailty (+/+) vs no frailty without social frailty (-/-)] were significant predictors of OS. Social frailty (subdistribution hazard ratio 3.23) and their combinations (7.57) were significant predictors of CSS. Conclusions and Implications: Preoperative social frailty is a predictor of OS and CSS in older patients with gastrointestinal cancer. Screening for social frailty, frailty, and their combinations in older patients with cancer is important. (c) 2021 AMDA d The Society for Post-Acute and Long-Term Care Medicine.

引用

页码：1825 / +

页数：7