The G8 screening tool detects relevant geriatric impairments and predicts survival in elderly patients with a haematological malignancy

被引:109
作者
Hamaker, Marije E. [1 ]
Mitrovic, M. [2 ]
Stauder, R. [2 ]
机构
[1] Diakonessen Hosp, Dept Geriatr Med, Utrecht, Netherlands
[2] Med Univ Innsbruck, Dept Internal Med Haematol & Oncol 5, A-6020 Innsbruck, Austria
关键词
Elderly; Geriatric assessment; Prognostication; Haematological malignancy; RECEIVING INDUCTION CHEMOTHERAPY; OLDER CANCER-PATIENTS; QUALITY-OF-LIFE; MYELODYSPLASTIC SYNDROMES; PROGNOSTIC VALUE; GAIT SPEED; ADULTS; FEASIBILITY; TOXICITY; IMPACT;
D O I
10.1007/s00277-013-2001-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The G8 screening tool was developed to separate fit older cancer patients who were able to receive standard treatment from those that should undergo a geriatric assessment to guide tailoring of therapy. We set out to determine the discriminative power and prognostic value of the G8 in older patients with a haematological malignancy. Between September 2009 and May 2013, a multi-dimensional geriatric assessment was performed in consecutive patients aged a parts per thousand yen67 years diagnosed with blood cancer at the Innsbruck University Hospital. The assessment included (instrumental) activities of daily living, cognition, mood, nutritional status, mobility, polypharmacy and social support. In parallel, the G8 was also administered (cut-off a parts per thousand currency sign 14). Using a cut-off of a parts per thousand yen2 impaired domains, 70 % of the 108 included patients were considered as having an impaired geriatric assessment while 61 % had an impaired G8. The G8 lacked discriminative power for impairments on full geriatric assessment: sensitivity 69, specificity 79, positive predictive value 89 and negative predictive value 50 %. However, G8 was an independent predictor of mortality within the first year after inclusion (hazard ratio 3.93; 95 % confidence interval 1.67-9.22, p < 0.001). Remarkably, patients with impaired G8 fared poorly, irrespective of treatment choices (p < 0.001). This is the first report on the clinical and prognostic relevance of G8 in elderly patients with haematological malignancies. Although the G8 lacked discriminative power for outcome of multi-dimensional geriatric assessment, this score appears to be a powerful prognosticator and could potentially represent a useful tool in treatment decisions. This novel finding certainly deserves further exploration.
引用
收藏
页码:1031 / 1040
页数:10
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