Association of frailty and malnutrition with overall survival in adults with gastrointestinal cancer:A prospective cohort study  

作　　者：Xi-Te Zheng Xiao-Rui Zhang Yi-Jun Zhang Feng-Yi Huang Yi-Jie Wang Ran Gao Quan-Mei Li Wan-Qi Liu Chu-Ning Luo Fen Liu Investigation on Nutrition Status and Clinical Outcome of Common Cancers(INSCOC)Group 

机构地区：[1]Department of Epidemiology and Health Statistics,School of Public Health,Beijing Municipal Key Laboratory of Clinical Epidemiology,Capital Medical University,Beijing 100069,China [2]不详

出　　处：《Journal of Nutritional Oncology》2024年第2期46-52,共7页肿瘤营养学杂志（英文）

基　　金：supported by the National Key Research and Development Program (No. 2022YFC2009600, No. 2022YFC2009601)

摘　　要：Background:Themortality burden of patients with gastrointestinalmalignancies is increasing worldwide,suggesting the need formore effective prognostic indicators.This study utilized a prospective cohort to(1)analyze the relationship between frailty and malnutrition and their association with the overall survival(OS)in adults with gastrointestinal cancer and(2)explore which specific frailty-related factors most significantly affect the OS.Methods:Participants diagnosed with gastrointestinal cancer from 2013 to 2018 who were enrolled in the Investigation on Nutrition Status and Clinical Outcome of Common Cancers study were identified.Malnutrition was determined using the Patient-Generated Subjective Global Assessment,whereas frailty was assessed using the FRAIL scale.The main outcome measured was the all-cause mortality.Multivariable-adjusted logistic regression was used to analyze the cross-sectional link between the nutritional status and frailty.Univariate and multivariate Cox regression analyses were conducted to explore the longitudinal association of these with the OS.Results:Among the 4,361 patients enrolled in the study,1,136 deaths were observed over a median follow-up of 43.4 months.Malnourished patients had a significantly higher risk of frailty than well-nourished patients(OR=6.25,95%CI=5.23–7.51).Frailty and malnutrition independently predicted the OS,with frailty showing an HR of 1.50(95%CI=1.33–1.69)and malnutrition showing an HR of 1.51(95%CI=1.31–1.74).Patientswith both frailty andmalnutrition had the highest all-causemortality risk(HR=1.82,95%CI=1.55–2.14)compared with patients with neither risk factor.Mortality rates rose with the accumulation of additional frailty-related factors.Conclusions:Malnutrition and frailty are interrelated prognostic factors in patients with gastrointestinalmalignancies,and their simultaneous presence worsens the patient outcomes.Higher scores for resistance and ambulation are major factors associated with a poorer outcome.Future large-scale prospective studies

关 键 词：FRAILTY MALNUTRITION MORTALITY Gastrointestinal cancer INSCOC 

分 类 号：R735[医药卫生—肿瘤] R459.3[医药卫生—临床医学]