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Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities

Introduction Geriatrics is a discipline that covers all adult healthcare, and oncology is no exception. The global geriatric assessment process plays a crucial role, impacting research, funding, resource allocation, as well as therapeutic decision-making. Thus, greater knowledge of the epidemiology...

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Autores principales: Guedes, Helena, Marinho, Joana, Neto, Ema, Custódio, Sandra, Costa, António, Veríssimo, Rafaela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561347/
https://www.ncbi.nlm.nih.gov/pubmed/37818491
http://dx.doi.org/10.7759/cureus.44940
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author Guedes, Helena
Marinho, Joana
Neto, Ema
Custódio, Sandra
Costa, António
Veríssimo, Rafaela
author_facet Guedes, Helena
Marinho, Joana
Neto, Ema
Custódio, Sandra
Costa, António
Veríssimo, Rafaela
author_sort Guedes, Helena
collection PubMed
description Introduction Geriatrics is a discipline that covers all adult healthcare, and oncology is no exception. The global geriatric assessment process plays a crucial role, impacting research, funding, resource allocation, as well as therapeutic decision-making. Thus, greater knowledge of the epidemiology of the frailty and functionality of elderly patients with cancer will allow for the development of a global care strategy. This study aimed to assess the prevalence of geriatric conditions in elderly cancer patients admitted to a medical geriatric unit following unplanned hospitalisation. Methods A retrospective, single-centre cohort study was conducted of patients aged ≥ 75 with an active oncological disease who were admitted to a geriatric medicine unit over a two-year period. Results A total of 65 patients were included. The median age was 85 (IQR 81-88), and 86% were aged ≥ 80. A moderate-to-high functional dependence was found: 67.7% on ≥ 3 basic activities of daily living (Katz ≥ D), with the majority classified as severely dependent based on the Barthel Index (mean 49.0 ± 33.7). Frailty was found in 90.7%. A high prevalence of geriatric syndromes was observed: malnutrition (84.6%), polypharmacy (64.6%), urinary incontinence (58.5%) and pressure ulcers (33.8%). The mortality rate was 36.9% during hospitalisation and 13.8%, 30 days post-discharge. Conclusions The study revealed a high prevalence of geriatric conditions, emphasising the importance of comprehensive assessment in managing elderly patients at different stages of the disease. This multidimensional and multidisciplinary approach optimises patient care throughout admission, hospitalisation and discharge.
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spelling pubmed-105613472023-10-10 Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities Guedes, Helena Marinho, Joana Neto, Ema Custódio, Sandra Costa, António Veríssimo, Rafaela Cureus Internal Medicine Introduction Geriatrics is a discipline that covers all adult healthcare, and oncology is no exception. The global geriatric assessment process plays a crucial role, impacting research, funding, resource allocation, as well as therapeutic decision-making. Thus, greater knowledge of the epidemiology of the frailty and functionality of elderly patients with cancer will allow for the development of a global care strategy. This study aimed to assess the prevalence of geriatric conditions in elderly cancer patients admitted to a medical geriatric unit following unplanned hospitalisation. Methods A retrospective, single-centre cohort study was conducted of patients aged ≥ 75 with an active oncological disease who were admitted to a geriatric medicine unit over a two-year period. Results A total of 65 patients were included. The median age was 85 (IQR 81-88), and 86% were aged ≥ 80. A moderate-to-high functional dependence was found: 67.7% on ≥ 3 basic activities of daily living (Katz ≥ D), with the majority classified as severely dependent based on the Barthel Index (mean 49.0 ± 33.7). Frailty was found in 90.7%. A high prevalence of geriatric syndromes was observed: malnutrition (84.6%), polypharmacy (64.6%), urinary incontinence (58.5%) and pressure ulcers (33.8%). The mortality rate was 36.9% during hospitalisation and 13.8%, 30 days post-discharge. Conclusions The study revealed a high prevalence of geriatric conditions, emphasising the importance of comprehensive assessment in managing elderly patients at different stages of the disease. This multidimensional and multidisciplinary approach optimises patient care throughout admission, hospitalisation and discharge. Cureus 2023-09-09 /pmc/articles/PMC10561347/ /pubmed/37818491 http://dx.doi.org/10.7759/cureus.44940 Text en Copyright © 2023, Guedes et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Guedes, Helena
Marinho, Joana
Neto, Ema
Custódio, Sandra
Costa, António
Veríssimo, Rafaela
Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities
title Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities
title_full Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities
title_fullStr Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities
title_full_unstemmed Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities
title_short Geriatric Assessment of Older Adults With Cancer During Acute Hospitalizations: Challenges and Opportunities
title_sort geriatric assessment of older adults with cancer during acute hospitalizations: challenges and opportunities
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561347/
https://www.ncbi.nlm.nih.gov/pubmed/37818491
http://dx.doi.org/10.7759/cureus.44940
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