在老年人中,新诊断出多发性骨髓瘤的功能状态与治疗接收和治疗结果的关联
Christopher Edward Jensen1, Tzy-Mey Kuo2, Matthew R LeBlanc3
1Division of Hematology, University of North Carolina School of Medicine, Chapel Hill, NC.
JCO clinical cancer informatics
|February 6, 2024
概括
残疾严重影响多发性骨髓瘤 (MM) 的老年人接受家庭卫生 (HH) 服务的死亡率. 严重的功能残疾预示着早期死亡,而中度残疾增加了急性护理需求.
科学领域:
- 血液瘤学 血液瘤学
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多发性骨髓瘤 (MM) 是老年人常见的一种癌症,通常与残疾和大量医疗保健使用有关.
- 这一群人经常使用家庭卫生 (HH) 服务,但残疾,HH使用和MM治疗之间的相互作用尚未得到充分理解.
研究的目的:
- 研究新诊断多发性骨髓瘤的老年人诊断前残疾,家庭卫生服务利用和治疗结果之间的关系.
- 检查功能状态如何影响该患者群体的死亡率和医疗保健利用率.
主要方法:
- 利用SEER-Medicare数据集识别了在2010-2017年间被诊断患有MM的66岁以上的成年人,他们之前曾使用过HH服务.
- 使用结果和评估信息集 (OASIS) 对日常生活活动的综合评分来评估残疾.
- 分析了死亡率,MM导向疗法接收和医疗保健利用模式.
主要成果:
- 在37,280名患有MM的老年人中,18.2%的人在诊断前使用了HH服务.
- 中等残疾人与轻度残疾人接受MM治疗的情况类似,但与严重残疾人相比,急性护理的利用率更高.
- HH使用者具有更大的并发症负担和增加的死亡率 (调整后3年死亡率的风险比:1.59). 严重的功能障碍强烈预测了诊断后的死亡率.
结论:
- 功能障碍是使用HH服务的老年MM患者早期死亡的关键预测因素.
- 中度残疾与可比的治疗强度相关,但急性护理利用率增加.
- 识别先前使用HH的患者可以帮助预测在MM治疗开始期间需要密集支持的需求.
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