老年肿瘤学与姑息治疗的整合:住院老年癌症患者的单一中心体验

W. Liguigli, R. Cengarle, A. Rimanti, G. Catania, L. Faglioni, S. Voltolini, C. Rabbi, R. Barbieri, Ilenia Zanardi Di Pietro, Beatrice Vivorio, P. Morselli, C. Iridile, Laura Rigotti, M. Cantore
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摘要

综合老年评估(CGA)用于规划老年人的社会和卫生保健,并完成肿瘤学家的诊断-治疗选择,同时考虑早期与姑息治疗相结合。年龄≥70岁的住院癌症患者(pts)采用G8问卷进行筛选,确定是否需要CGA。CGA鉴定:健康、不健康和虚弱。我们通过G8筛查了95例患者,其中93例(98%)处于危险之中。经CGA评估的高危患者:健康3例,不健康45例,体弱45例。3例患者接受标准内科或外科治疗。41例不适应患者(91%)接受了个性化护理,4例患者病情迅速恶化而死亡。平均年龄为76岁,平均IADL/ADL(工具性/日常生活活动)评分为5分。31%的人存在营养不良,62%的人MMSE(精神状态检查)正常。在这45名患者中,32人死亡,平均生存期为120天:14人在家中,13人在临终关怀中,5人在住院期间。45例体弱患者中,3例接受个性化护理,42例接受最佳支持性护理。中位年龄为81岁,中位评分IADL/ADL为2。55%的人存在营养不良,22%的人MMSE正常。在这45名患者中,40人死亡,平均生存期为36天:12人在家中,24人在临终关怀中,4人在住院期间。身体不健康的病人比身体虚弱的病人有更好的功能、认知和营养状况。老年肿瘤学和姑息治疗之间的早期整合代表了创造个性化护理途径的可能性,特别是对体弱患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Integration between Geriatric Oncology and Palliative Care: A Single Center Experience for Hospitalized Older Patients with Cancer
Comprehensive Geriatric Assessment (CGA) is utilized to plan social and health care of the elderly and to complete the diagnostic-therapeutic choice of oncologist also considering early integration with palliative care. Cancer patients (pts) hospitalized aged ≥70 years were screened by the G8 questionnaire to define if necessary CGA. CGA identified: fit, unfit and frail pts. We screened 95 pts by G8 and 93 (98%) were at risk. Pts at risk, evaluated by CGA resulted: 3 fit, 45 unfit and 45 frail. 3 fit pts received standard medical or surgical therapy. 41 unfit pts (91%) received personalized care and 4 pts got worse quickly and died. The median age was 76 and median score IADL/ADL (Instrumental/Activities Daily Living) was 5. Malnutrition was present in 31% and MMSE (Mini-Mental State Examination) was normal in 62%. Among these 45 pts, 32 died with a median survival of 120 days: 14 at home, 13 in hospice and 5 during hospitalization. Among 45 frail pts, 3 received personalized care and 42 received the Best Supportive Care. The median age was 81 and the median score IADL/ADL was 2. Malnutrition was present in 55%, and MMSE was normal in 22%. Among these 45 pts 40 died with a median survival of 36 days: 12 at home, 24 in hospice, and 4 during hospitalization. Unfit pts have a better functional, cognitive and nutritional status than frail pts. Early integration between geriatric oncology and palliative care represents the possibility of create a personalized care pathway especially for frail pts.
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