Prognostic assessment in palliative cancer care: is there a difference between adult and older patients?

• Autor(a) principal: Sampaio,Simone Garruth dos Santos Machado
• Data de Publicação: 2021
• Outros Autores: Oliveira,Livia Costa, Rosa,Karla Santos da Costa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Geriatrics, Gerontology and Aging (Online)
• Texto Completo: https://ggaging.com/details/1699
• topic: palliative care; prognosis; inflammation; nutritional status.

<p><b>OBJECTIVE:</b> To compare factors associated with death in adults and older people with advanced cancer who were hospitalized in a palliative care unit (PCU).<br> <b>METHODS:</b> Case-control study with patients (adults vs older people) admitted to a PCU of National Cancer Institute José Alencar Gomes da Silva (INCA), in Rio de Janeiro, Brazil. Logistic regressions (odds ratio [OR] and 95% confidence interval [95%CI]) were used to identify factors associated with death.<br> <b>RESULTS:</b> The study included 205 patients, most of which were aged over 60 years old (60.5%). Among the adult patients, a Karnofsky Performance Status &le; 40% (OR 2.54 [95%CI 1.11–3.45]) and neutrophil-to-lymphocyte ratio (NLR) (OR 1.09 [95%CI 1.02–1.24]) were risk factors for death, while albumin (OR 0.30 [95%CI 0.12–0.78]) was a protective factor. Among older patients, NLR (OR: 1.13 [95%CI 1.02–1.24]), C-reactive protein (CRP) (OR 1.09 [95%CI 1.02–1.17]), modified Glasgow Prognostic Score (mGPS) 1 and 2 (OR 4.66 [95%CI 1.35–16.06]), CRP-to-albumin ratio (CAR) (OR 1.27 [95%CI 1.03–1.58]), and nutritional risk (OR 1.11 [95%CI 1.03–1.19]) were risk factors, whereas albumin (OR 0.23 [95%CI 0.09–0.57]) was a protective factor against death.<br> <b>CONCLUSIONS:</b> Prognostic factors differed between groups. The NLR was a risk factor, and albumin was a protective factor regarding death in both groups. Additionally, CRP, mGPS, CAR, and nutritional risk were associated with an increased risk of death only among older people.</p>