Functional status in older patients with lung cancer: an observational cohort study

Purpose An assessment of the impact of functional status (FS) evaluated using a combination of Activities of Daily Living (ADL) and the short version of the Instrumental Activities of Daily Living (IADL), on 3- and 6- month mortality and on 3-month unplanned hospitalizations in older patients treate...

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Bibliographic Details
Published in:Supportive care in cancer 2022-05, Vol.30 (5), p.3817-3827
Main Authors: Couderc, Anne-Laure, Tomasini, Pascale, Greillier, Laurent, Nouguerède, Emilie, Rey, Dominique, Montegut, Coline, Thomas, Pascal-Alexandre, Barlesi, Fabrice, Villani, Patrick
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Aged patients
Analysis
Cancer
Cancer patients
Care and treatment
Cognition disorders
Cohort analysis
Cohort Studies
Functional Status
Geriatric Assessment - methods
Health aspects
Humanities and Social Sciences
Humans
Life Sciences
Lung cancer
Lung Neoplasms
Male
Medical screening
Medicine
Medicine & Public Health
Mortality
Nursing
Nursing Research
Observational studies
Older people
Oncology
Oncology, Experimental
Original Article
Pain Medicine
Physical fitness
Rehabilitation Medicine
Retrospective Studies
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Summary:Purpose An assessment of the impact of functional status (FS) evaluated using a combination of Activities of Daily Living (ADL) and the short version of the Instrumental Activities of Daily Living (IADL), on 3- and 6- month mortality and on 3-month unplanned hospitalizations in older patients treated for lung cancers. Method and objectives This observational retrospective study was conducted between September 2015 and January 2019 at Marseille University Hospital (AP-HM). During this period, all consecutive outpatients aged 70 years or older referred for a comprehensive geriatric assessment (CGA) before the initiation of lung cancer treatment were enrolled. Results Two hundred twenty-seven patients were analyzed: the median age was 78.7 years and 74.0% were male. Almost half of the patients were metastatic (45.4%). Concerning FS, 41.9% of patients had no ADL-IADL impairment, 30.0% had either IADL or ADL impairment, and both ADL-IADL were impaired for 28.1%. Impaired ADL-IADL was associated with poor nutritional status, depression, mobility, and cognitive disorders. In a logistic regression model, ADL or IADL impairment ( aOR  = 2.1; 95% CI [1.0–4.2]; p  = 0.037) and impaired ADL-IADL ( aOR  = 2.6; 95% CI [1.2–5.3]; p  = 0.012) were independently associated with a higher risk of unplanned hospitalizations within 3 months. In the multivariate Cox model, 6-month mortality risk was independently associated with impaired ADL-IADL ( aHR  = 2.3; 95% CI [1.3–4.4]; p  = 0.008). Conclusion The combination of ADL and IADL scales to assess FS is a prognostic marker of the mortality risk at 6 months in older patients with lung cancer and should be more largely used by oncologists in treatment decision making.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-021-06752-2