Teodoro J. Oscanoa, Edwin Cieza-Macedo, Xavier Vidal, Roman Romero-Ortuno
{"title":"在老年癌症患者中筛查易感和虚弱的time Up and Go试验的评价","authors":"Teodoro J. Oscanoa, Edwin Cieza-Macedo, Xavier Vidal, Roman Romero-Ortuno","doi":"10.5603/ocp.96855","DOIUrl":null,"url":null,"abstract":"Introduction. The need for comprehensive geriatric assessment (CGA) in older adults with cancer is increasing, which makes it necessary to have a screening instrument to identify those who would benefit from this evaluation. This study aimed to investigate diagnostic performance of the Timed Up and Go test (TUG) for identifying vulnerable or frail older adults with cancer who might benefit from CGA. Material and methods. This observational and retrospective study took place at the geriatric center of Almenara Hospital in Lima, Peru. We extracted CGA reports from electronic medical records of outpatients and inpatients aged 60 years and older with cancer, who were evaluated between November 2022 and July 2023. Patients were classified based on SIOG-2 (International Society of Geriatric Oncology) criteria as fit, vulnerable, or frail, based on scales including Activities of Daily Living (ADL), Instrumental ADL, Mini-Nutritional Assessment (MNA), Mini-Mental State Exam (MMSE), Geriatric Depression Scale, and Cumulative Illness Rating Scale-Geriatrics (CIRS-G). For the study, two groups were formed: fit patients and non-fit patients (vulnerable plus frail). We estimated sensitivity, specificity, and positive predictive values of the TUG test. The accuracy of the TUG test was analyzed using the area under the receiver operating characteristic curve (AUC). Results. Among the 283 included patients, 154 were men (54.4%) and 129 women (45.6%), and the mean age was 76.8 ± 15.8 years. The most common neoplasms were colorectal (19.4%), stomach (15.2%), prostate (9.9%), and bile duct cancers (8.1%). The percentage of fit and non-fit patients was 21.9% and 78.1%, respectively. When the TUG test was equal to or greater than 15.5 seconds, sensitivity, specificity, positive predictive value, and AUC were 68.5% (95% CI 61.9–74.5), 88.5% (77.8–95.3), 95.6% (91.1–98.2), and 84.8% (0.80–0.90), respectively. Conclusions. A TUG test result equal to or greater than 15.5 seconds demonstrated good screening properties for identifying older cancer patients who were vulnerable or frail and could benefit from CGA.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"68 1","pages":"0"},"PeriodicalIF":0.3000,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the Timed Up and Go test for screening vulnerability and frailty in older cancer patients\",\"authors\":\"Teodoro J. Oscanoa, Edwin Cieza-Macedo, Xavier Vidal, Roman Romero-Ortuno\",\"doi\":\"10.5603/ocp.96855\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction. The need for comprehensive geriatric assessment (CGA) in older adults with cancer is increasing, which makes it necessary to have a screening instrument to identify those who would benefit from this evaluation. This study aimed to investigate diagnostic performance of the Timed Up and Go test (TUG) for identifying vulnerable or frail older adults with cancer who might benefit from CGA. Material and methods. This observational and retrospective study took place at the geriatric center of Almenara Hospital in Lima, Peru. We extracted CGA reports from electronic medical records of outpatients and inpatients aged 60 years and older with cancer, who were evaluated between November 2022 and July 2023. Patients were classified based on SIOG-2 (International Society of Geriatric Oncology) criteria as fit, vulnerable, or frail, based on scales including Activities of Daily Living (ADL), Instrumental ADL, Mini-Nutritional Assessment (MNA), Mini-Mental State Exam (MMSE), Geriatric Depression Scale, and Cumulative Illness Rating Scale-Geriatrics (CIRS-G). For the study, two groups were formed: fit patients and non-fit patients (vulnerable plus frail). We estimated sensitivity, specificity, and positive predictive values of the TUG test. The accuracy of the TUG test was analyzed using the area under the receiver operating characteristic curve (AUC). Results. Among the 283 included patients, 154 were men (54.4%) and 129 women (45.6%), and the mean age was 76.8 ± 15.8 years. The most common neoplasms were colorectal (19.4%), stomach (15.2%), prostate (9.9%), and bile duct cancers (8.1%). The percentage of fit and non-fit patients was 21.9% and 78.1%, respectively. When the TUG test was equal to or greater than 15.5 seconds, sensitivity, specificity, positive predictive value, and AUC were 68.5% (95% CI 61.9–74.5), 88.5% (77.8–95.3), 95.6% (91.1–98.2), and 84.8% (0.80–0.90), respectively. Conclusions. A TUG test result equal to or greater than 15.5 seconds demonstrated good screening properties for identifying older cancer patients who were vulnerable or frail and could benefit from CGA.\",\"PeriodicalId\":42942,\"journal\":{\"name\":\"Oncology in Clinical Practice\",\"volume\":\"68 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2023-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oncology in Clinical Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5603/ocp.96855\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology in Clinical Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5603/ocp.96855","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
介绍。对患有癌症的老年人进行综合老年评估(CGA)的需求正在增加,这使得有必要有一种筛查工具来确定那些将从这种评估中受益的人。本研究旨在探讨time Up and Go测试(TUG)的诊断性能,以识别可能受益于CGA的脆弱或虚弱的老年癌症患者。材料和方法。这项观察性和回顾性研究在秘鲁利马Almenara医院的老年中心进行。我们从2022年11月至2023年7月期间评估的60岁及以上癌症门诊和住院患者的电子病历中提取了CGA报告。根据SIOG-2(国际老年肿瘤学会)标准,根据日常生活活动(ADL)、工具ADL、迷你营养评估(MNA)、迷你精神状态检查(MMSE)、老年抑郁量表和累积疾病评定量表-老年病学(CIRS-G)等量表,将患者分为健康、易受伤害或虚弱。在这项研究中,分为两组:健康患者和非健康患者(脆弱加虚弱)。我们估计了TUG试验的敏感性、特异性和阳性预测值。利用接收机工作特性曲线下面积(AUC)对TUG试验的精度进行了分析。结果。283例患者中,男性154例(54.4%),女性129例(45.6%),平均年龄76.8±15.8岁。最常见的肿瘤是结直肠癌(19.4%)、胃癌(15.2%)、前列腺癌(9.9%)和胆管癌(8.1%)。适合和不适合患者的比例分别为21.9%和78.1%。当TUG试验≥15.5秒时,灵敏度、特异度、阳性预测值和AUC分别为68.5% (95% CI 61.9 ~ 74.5)、88.5% (95% CI 77.8 ~ 95.3)、95.6% (95% CI 91.1 ~ 98.2)和84.8%(0.80 ~ 0.90)。结论。TUG测试结果等于或大于15.5秒,显示出良好的筛选特性,可以识别易受伤害或虚弱的老年癌症患者,并可能从CGA中受益。
Evaluation of the Timed Up and Go test for screening vulnerability and frailty in older cancer patients
Introduction. The need for comprehensive geriatric assessment (CGA) in older adults with cancer is increasing, which makes it necessary to have a screening instrument to identify those who would benefit from this evaluation. This study aimed to investigate diagnostic performance of the Timed Up and Go test (TUG) for identifying vulnerable or frail older adults with cancer who might benefit from CGA. Material and methods. This observational and retrospective study took place at the geriatric center of Almenara Hospital in Lima, Peru. We extracted CGA reports from electronic medical records of outpatients and inpatients aged 60 years and older with cancer, who were evaluated between November 2022 and July 2023. Patients were classified based on SIOG-2 (International Society of Geriatric Oncology) criteria as fit, vulnerable, or frail, based on scales including Activities of Daily Living (ADL), Instrumental ADL, Mini-Nutritional Assessment (MNA), Mini-Mental State Exam (MMSE), Geriatric Depression Scale, and Cumulative Illness Rating Scale-Geriatrics (CIRS-G). For the study, two groups were formed: fit patients and non-fit patients (vulnerable plus frail). We estimated sensitivity, specificity, and positive predictive values of the TUG test. The accuracy of the TUG test was analyzed using the area under the receiver operating characteristic curve (AUC). Results. Among the 283 included patients, 154 were men (54.4%) and 129 women (45.6%), and the mean age was 76.8 ± 15.8 years. The most common neoplasms were colorectal (19.4%), stomach (15.2%), prostate (9.9%), and bile duct cancers (8.1%). The percentage of fit and non-fit patients was 21.9% and 78.1%, respectively. When the TUG test was equal to or greater than 15.5 seconds, sensitivity, specificity, positive predictive value, and AUC were 68.5% (95% CI 61.9–74.5), 88.5% (77.8–95.3), 95.6% (91.1–98.2), and 84.8% (0.80–0.90), respectively. Conclusions. A TUG test result equal to or greater than 15.5 seconds demonstrated good screening properties for identifying older cancer patients who were vulnerable or frail and could benefit from CGA.