Influencing Factors and a Predictive Nomogram of Frailty in Chinese Patients with Cancer: A Single-Center Retrospective Study

IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES European Journal of Cancer Care Pub Date : 2024-09-23 DOI:10.1155/2024/3194941
Zhihui Yang, Yuanyuan Luo, Jiahui Luo, Qinghong Fang, Jingxia Miao, Lili Zhang
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Abstract

Objective. The number of cancer survivors is increasing, and the high prevalence of frailty not only reduces quality of life but also affects the treatment of cancer patients. This study aimed to identify the prevalence and risk factors of frailty in cancer patients and to construct a nomogram to predict the probability of frailty. Methods. Nine hundred fifty-eight cancer patients were included in this retrospective study, randomly divided into a development set (n = 680) and a validation set (n = 278). Frailty was assessed using the Tilburg frailty indicator (TFI). Social support, medical coping styles, and psychological distress were assessed by the Social Support Self-Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ), and distress thermometer (DT), respectively. Results. The prevalence of frailty in cancer patients was 45.93%. Cancer patients who exercised regularly, ate a balanced diet, and actively coped with diseases were less likely to become frail. The risk factors for frailty identified by a multivariate analysis were parenteral nutrition, advanced TNM staging, vegetarian diet, unemployment, psychological distress ≥4, low physical activity, and negative coping styles. These risk factors were used to construct a nomogram, and the C-index, calibration curve, and decision curve analysis (DCA) were used to assess the performance of the nomogram. The C-index was 0.762, and the calibration curve showed satisfactory coherence. The net benefit of the nomogram was better between threshold probabilities of 17%–96% in DCA. Conclusion. Special focus needs to be placed on frail cancer patients due to their high prevalence and severe outcomes. Clinical medical workers could use this nomogram to identify high-risk patients and intervene early to prevent frailty.

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中国癌症患者体质虚弱的影响因素和预测示意图:单中心回顾性研究
目的。癌症幸存者的人数在不断增加,而体弱的高患病率不仅降低了生活质量,还影响了癌症患者的治疗。本研究旨在确定癌症患者体弱的发生率和风险因素,并构建预测体弱概率的提名图。研究方法这项回顾性研究共纳入 958 名癌症患者,随机分为开发组(n = 680)和验证组(n = 278)。虚弱程度采用蒂尔堡虚弱指标(TFI)进行评估。社会支持、医疗应对方式和心理困扰分别通过社会支持自评量表(SSRS)、医疗应对方式问卷(MCMQ)和困扰温度计(DT)进行评估。结果癌症患者体弱的发生率为 45.93%。经常锻炼、饮食均衡、积极应对疾病的癌症患者体弱的可能性较低。多变量分析确定的体弱风险因素包括肠外营养、TNM 分期晚期、素食、失业、心理压力≥4、体力活动少和消极应对方式。这些风险因素被用来构建一个提名图,并用C指数、校准曲线和决策曲线分析(DCA)来评估提名图的性能。C 指数为 0.762,校准曲线显示出令人满意的一致性。在 DCA 中,在阈值概率为 17%-96% 之间,提名图的净效益更好。结论由于体弱癌症病人发病率高且后果严重,因此需要特别关注他们。临床医务工作者可使用该提名图来识别高危患者,并及早干预以预防虚弱。
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来源期刊
European Journal of Cancer Care
European Journal of Cancer Care 医学-康复医学
CiteScore
4.00
自引率
4.80%
发文量
213
审稿时长
3 months
期刊介绍: The European Journal of Cancer Care aims to encourage comprehensive, multiprofessional cancer care across Europe and internationally. It publishes original research reports, literature reviews, guest editorials, letters to the Editor and special features on current issues affecting the care of cancer patients. The Editor welcomes contributions which result from team working or collaboration between different health and social care providers, service users, patient groups and the voluntary sector in the areas of: - Primary, secondary and tertiary care for cancer patients - Multidisciplinary and service-user involvement in cancer care - Rehabilitation, supportive, palliative and end of life care for cancer patients - Policy, service development and healthcare evaluation in cancer care - Psychosocial interventions for patients and family members - International perspectives on cancer care
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