在临床试验中的老年晚期癌症患者中,开发和验证用于急性护理的风险预测模型
Dawn L Hershman1,2,3, Cathee Till1,2,3, Michael Leblanc1,2,3
1Columbia University, New York, NY, USA.
Journal of the National Cancer Institute
|December 5, 2025
概括
晚期癌症的老年患者面临急诊和住院住院的高风险. 一个简单的4因素模型识别了那些最有可能需要急性护理的人,从而实现了有针对性的干预.
科学领域:
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有晚期癌症的患者容易受到计划外的急诊室 (ED) 访问和住院 (HS) 的影响.
- 识别高风险个体对于积极的医疗保健管理和资源分配至关重要.
研究的目的:
- 开发和验证一种预测模型,用于在晚期癌症的老年人中使用急性护理.
- 确定与非计划ED访问和HS相关的关键风险因素.
主要方法:
- 从SWOG试验 (1999-2014) 中使用的与晚期癌症患者 (≥65岁) 相关的Medicare索赔数据.
- 使用训练套件 (60%的患者) 开发了一个风险预测模型,并对剩余的40%进行了验证.
- 确定了不良风险因素,包括表现状况,冠状动脉疾病,高血压和肝脏疾病.
主要成果:
- 该模型确定了≥2个不良因素 (高风险组) 的患者,其急性护理使用几率增加了3倍以上 (OR=3.38).
- 高风险患者 (57.3%) 与低风险患者 (42.7%) 相比,急性护理的发生率更高 (79.6%).
- 该模型证明了成功验证,在测试组中获得了类似的结果 (C-统计=0.703).
结论:
- 一组简短的四个变量有效地预测了晚期癌症的老年人急性护理利用的风险增加了三倍.
- 这种风险预测模型可以为个性化干预提供信息,以减少急性护理的使用,并提高癌症护理的质量.
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