Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data

Yuting Wang,*,1 Rui Zhang*,2 Yanjiao Shen,1,3 Lin Su,1 Birong Dong,1 Qiukui Hao11The Center of Gerontology and Geriatrics/National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Health Informatics Cen...

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Autores principales:	Wang Y, Zhang R, Shen Y, Su L, Dong B, Hao Q
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	frailty prognosis older patients lung cancer chemotherapy. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/6afd57f7f8d44f10973bf55c5039cfc9
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spelling	oai:doaj.org-article:6afd57f7f8d44f10973bf55c5039cfc92021-12-02T06:58:11ZPrediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data1178-1998https://doaj.org/article/6afd57f7f8d44f10973bf55c5039cfc92019-07-01T00:00:00Zhttps://www.dovepress.com/prediction-of-chemotherapy-adverse-reactions-and-mortality-in-older-pa-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yuting Wang,,1 Rui Zhang,2 Yanjiao Shen,1,3 Lin Su,1 Birong Dong,1 Qiukui Hao11The Center of Gerontology and Geriatrics/National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Health Informatics Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workObjectives: To assess the role of a pre-chemotherapy frailty index based on routine laboratory data in predicting mortality and chemotherapy adverse reactions among older patients with primary lung cancer.Design: Retrospective cohort studySetting: West China Hospital, Chengdu, ChinaParticipants: We included patients aged ≥60 years with primary lung cancer receiving the first course of chemotherapy.Measurements: Data were collected from medical records, local government death databases or telephone interviews. Outcomes included chemotherapy adverse reactions and all-cause mortality. We constructed a frailty index based on 44 laboratory variables (FI-LAB) before chemotherapy, and chose the following cutoff points: robust (0.0–0.2), pre-frail (0.2–0.35) and frail (≥0.35).Results: We included 1,020 patients (71.4% male; median age: 65 years old). Both pre-frailty and frailty was associated with any chemotherapy adverse reactions and infections during chemotherapy (OR=3.48, 95%CI: 1.77–6.87; OR=3.58, 95%CI: 1.55–8.26, respectively). Frail patients had a shorter median overall survival rate compared to robust patients (18.05 months vs 38.89 months, log-rank p<0.001). After adjusting for some potential confounding variables, the risk of all-cause mortality was dramatically increased in frail patients (HR:2.13, 95% CI:1.51–3.00) with an average follow-up of 3.9 years. Each 0.01 or per standard deviation (SD) increase in the FI-LAB value significantly increased the HR of death by 2.0% (HR:1.02, 95% CI: 1.01–1.03) and 23.0% (HR: 1.23, 95% CI: 1.13–1.34), respectively.Conclusions: Frailty assessed by routine laboratory data indicates increased risks of chemotherapy adverse reactions and death in older patients with primary lung cancer receiving the first course of chemotherapy.Keywords: frailty, prognosis, older patients, lung cancer, chemotherapyWang YZhang RShen YSu LDong BHao QDove Medical Pressarticlefrailtyprognosisolder patientslung cancerchemotherapy.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 1187-1197 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	frailty prognosis older patients lung cancer chemotherapy. Geriatrics RC952-954.6
spellingShingle	frailty prognosis older patients lung cancer chemotherapy. Geriatrics RC952-954.6 Wang Y Zhang R Shen Y Su L Dong B Hao Q Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
description	Yuting Wang,,1 Rui Zhang,2 Yanjiao Shen,1,3 Lin Su,1 Birong Dong,1 Qiukui Hao11The Center of Gerontology and Geriatrics/National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Health Informatics Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workObjectives: To assess the role of a pre-chemotherapy frailty index based on routine laboratory data in predicting mortality and chemotherapy adverse reactions among older patients with primary lung cancer.Design: Retrospective cohort studySetting: West China Hospital, Chengdu, ChinaParticipants: We included patients aged ≥60 years with primary lung cancer receiving the first course of chemotherapy.Measurements: Data were collected from medical records, local government death databases or telephone interviews. Outcomes included chemotherapy adverse reactions and all-cause mortality. We constructed a frailty index based on 44 laboratory variables (FI-LAB) before chemotherapy, and chose the following cutoff points: robust (0.0–0.2), pre-frail (0.2–0.35) and frail (≥0.35).Results: We included 1,020 patients (71.4% male; median age: 65 years old). Both pre-frailty and frailty was associated with any chemotherapy adverse reactions and infections during chemotherapy (OR=3.48, 95%CI: 1.77–6.87; OR=3.58, 95%CI: 1.55–8.26, respectively). Frail patients had a shorter median overall survival rate compared to robust patients (18.05 months vs 38.89 months, log-rank p<0.001). After adjusting for some potential confounding variables, the risk of all-cause mortality was dramatically increased in frail patients (HR:2.13, 95% CI:1.51–3.00) with an average follow-up of 3.9 years. Each 0.01 or per standard deviation (SD) increase in the FI-LAB value significantly increased the HR of death by 2.0% (HR:1.02, 95% CI: 1.01–1.03) and 23.0% (HR: 1.23, 95% CI: 1.13–1.34), respectively.Conclusions: Frailty assessed by routine laboratory data indicates increased risks of chemotherapy adverse reactions and death in older patients with primary lung cancer receiving the first course of chemotherapy.Keywords: frailty, prognosis, older patients, lung cancer, chemotherapy
format	article
author	Wang Y Zhang R Shen Y Su L Dong B Hao Q
author_facet	Wang Y Zhang R Shen Y Su L Dong B Hao Q
author_sort	Wang Y
title	Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
title_short	Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
title_full	Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
title_fullStr	Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
title_full_unstemmed	Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
title_sort	prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/6afd57f7f8d44f10973bf55c5039cfc9
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Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data

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