{"title":"Influencing Factors and a Predictive Nomogram of Frailty in Chinese Patients with Cancer: A Single-Center Retrospective Study","authors":"Zhihui Yang, Yuanyuan Luo, Jiahui Luo, Qinghong Fang, Jingxia Miao, Lili Zhang","doi":"10.1155/2024/3194941","DOIUrl":null,"url":null,"abstract":"<div>\n <p><i>Objective</i>. 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. <i>Methods</i>. Nine hundred fifty-eight cancer patients were included in this retrospective study, randomly divided into a development set (<i>n</i> = 680) and a validation set (<i>n</i> = 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. <i>Results</i>. 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. <i>Conclusion</i>. 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.</p>\n </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3194941","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Cancer Care","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/3194941","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
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.
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