Construction and evaluation of a risk assessment model for asthenic syndrome in patients with malignant tumors
WEI Jiejing1* LU Ting2* YING Yanping3 HUANG Biaojin3 XU Yi4
1.Department of Oncology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning 530021, China; 2.Daytime Chemotherapy Center, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning 530021, China; 3.Department of Nursing, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning 530021, China; 4.Department of Thoracic Surgery, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, Guilin 541002, China
Abstract：Objective To investigate the related factors of asthenic syndrome in patients with malignant tumors, and construct a risk assessment model to predict its efficacy. Methods A total of 327 patients with malignant tumors who were hospitalized in the oncology department of a top-three hospital in Guangxi from May to August 2020 were selected. General data and laboratory indicators of the patients were collected, and grip strength was measured. The risk assessment model was determined by binary logistic regression analysis, and the model effect was tested by subject working characteristic curve. Results The incidence of asthenic syndrome in malignant tumor patients was 28.4%. There were significant differences in gender, age, grip strength, arm circumference, calf circumference, body mass index, erythrocyte, hemoglobin, total protein, albumin and prealbumin between the two groups (P＜0.05). Logistic regression results showed that gender, grip strength, arm circumference and albumin were the influencing factors of asthenic syndrome in malignant tumor patients (OR＜1, P＜0.05). H-L goodness of fit test was used to test the FMS risk prediction model (P＞0.05), and the model fit was good. When the area under ROC curve was 0.852 (95%CI: 0.807-0.897, P＜0.05), the sensitivity was 0.849, and the specificity was 0.722, the Youden index was the largest (0.572), and the prediction model score was 149 points. Conclusion The incidence of asthenic syndrome is high in patients with malignant tumors, and female patients and lower arm circumference, grip strength and albumin are risk factors for asthenic syndrome in patients with malignant tumors. 149 points is the optimal threshold value for the asthenic syndrome risk assessment model in patients with malignant tumors. The constructed asthenic syndrome risk assessment model has good diagnostic efficacy and can be verified in the next large sample.
韦洁静1* 卢婷2* 应燕萍3 黄彪进3 徐谊4. 恶性肿瘤患者衰弱综合征风险评估模型的构建与评价[J]. 中国医药导报, 2023, 20(24): 59-63.
WEI Jiejing1* LU Ting2* YING Yanping3 HUANG Biaojin3 XU Yi4. Construction and evaluation of a risk assessment model for asthenic syndrome in patients with malignant tumors. 中国医药导报, 2023, 20(24): 59-63.
[1] Hirpara DH，Kidane B，Rogalla P，et al. Frailty assessment prior to thoracic surgery for lung or esophageal cancer：a feasibility study [J]. Support Care Cancer，2019，27（4）：1535- 1540.
[2] Souza NC，Gonzalez MC，Martucci RB，et al. Frailty is associated with myosteatosis in obese patients with colorectal cancer [J]. Clin Nutr，2020，39（2）：484-491.
[3] 裴丽，田昕玉，窦昊颖，等.老年衰弱综合症与慢性病的研究进展[J].中国老年学杂志，2020，40（20）：4471-4473.
[4] Ethun CG，Bilen MA，Jani AB，et al. Frailty and cancer：Implications for oncology surgery，medical oncology，and radiation oncology [J]. CA Cancer J Clin，2017，67（5）：362-377.
[5] Mohile SG，Xian Y，Dale W，et al. Association of a cancer diagnosis with vulnerability and frailty in older Medicare beneficiaries [J]. J Natl Cancer Inst，2009，101（17）：1206- 1215.
[6] Robinson TN，Walston JD，Brummel NE，et al. Frailty for Surgeons：Review of a National Institute on Aging Conference on Frailty for Specialists [J]. J Am Coll Surg，2015，221（6）：1083-1092.
[7] Lu J，Cao LL，Zheng CH，et al. The Preoperative Frailty Versus Inflammation-Based Prognostic Score：Which is Better as an Objective Predictor for Gastric Cancer Patients 80 Years and Older? [J]. Ann Surg Oncol，2017，24（3）：754-762.
[8] Pitts KD，Arteaga AA，Stevens BP，et al. Frailty as a Predictor of Postoperative Outcomes among Patients with Head and Neck Cancer [J]. Otolaryngol Head Neck Surg，2019，160（4）： 664-671.
[9] George EL，Chen R，Trickey AW，et al. Variation in center- level frailty burden and the impact of frailty on long-term survival in patients undergoing elective repair for abdominal aortic aneurysms [J]. J Vasc Surg，2020，71（1）：46-55.e4.
[10] Handforth C，Clegg A，Young C，et al. The prevalence and outcomes of frailty in older cancer patients：a systematic review [J]. Ann Oncol，2015，26（6）：1091-1101.
[11] 卢婷，应燕萍，赵慧涵，等.恶性肿瘤患者握力的影响因素分析[J].护理学报，2020，27（6）：1-4.
[12] Merchant RA，Chen MZ，Wong B，et al. Relationship Between Fear of Falling，Fear-Related Activity Restriction，Frailty，and Sarcopenia [J]. J Am Geriatr Soc，2020，68（11）： 2602-2608.
[13] Velghe A，De Buyser S，Noens L，et al. Hand grip strength as a screening tool for frailty in older patients with haematological malignancies [J]. Acta Clin Belg，2016，71（4）：227- 230.
[14] Shalini T，Chitra PS，Kumar BN，et al. Frailty and Nutritional Status among Urban Older Adults in South India [J]. J Aging Res，2020，2020：8763413.
[15] 董娟，赵籥陶，李晶，等.衰弱综合症与营养不良关系的研究进展[J].中华老年医学杂志，2016，35（8）：907-909.
[16] Dent E，Visvanathan R，Piantadosi C，et al. Use of the Mini Nutritional Assessment to detect frailty in hospitalised older people [J]. J Nutr Health Aging，2012，16（9）：764-767.
[17] Valentini A，Federici M，Cianfarani MA，et al. Frailty and nutritional status in older people：the Mini Nutritional Assessment as a screening tool for the identification of frail subjects [J]. Clin Interv Aging，2018，13：1237-1244.
[18] Luger E，Dorner TE，Haider S，et al. Effects of a Home- Based and Volunteer-Administered Physical Training，Nutritional，and Social Support Program on Malnutrition and Frailty in Older Persons：A Randomized Controlled Trial [J]. J Am Med Dir Assoc，2016，17（7）：671.e9-671.e16.
[19] Kim H，Suzuki T，Kim M，et al. Incidence and predictors of sarcopenia onset in community-dwelling elderly Japanese women：4-year follow-up study [J]. J Am Med Dir Assoc，2015，16（1）：85.e1-8.
[20] Liang YD，Zhang YN，Li YM，et al. Identification of Frailty and Its Risk Factors in Elderly Hospitalized Patients from Different Wards：A Cross-Sectional Study in China [J]. Clin Interv Aging，2019，14：2249-2259.
[21] Pang B，Wee SL，Lau LK，et al. Prevalence and Associated Factors of Sarcopenia in Singaporean Adults-The Yishun Study [J]. J Am Med Dir Assoc，2021，22（4）：885e1-885e10.
[22] Lino VT，Rodrigues NC，O’Dwyer G，et al. Handgrip Strength and Factors Associated in Poor Elderly Assisted at a Primary Care Unit in Rio de Janeiro，Brazil [J]. PLoS One，2016， 11（11）：e0166373.
[23] Koll TT，Rosko AE. Frailty in Hematologic Malignancy [J]. Curr Hematol Malig Rep，2018，13（3）：143-154.
[24] Crocker TF，Brown L，Clegg A，et al. Quality of life is substantially worse for community-dwelling older people living with frailty：systematic review and meta-analysis [J]. Qual Life Res，2019，28（8）：2041-2056.
[25] Kirkhus L，■altyt■ Benth J，Gr?覬nberg BH，et al. Frailty iden- tified by geriatric assessment is associated with poor functioning，high symptom burden and increased risk of physical decline in older cancer patients：Prospective observational study [J]. Palliat Med，2019，33（3）：312-322.
京公网安备 11010502046598号