Survival Analysis: Handgrip Strength and Cancer Staging in the Elderly Cancer Patients
Date Issued
2012
Date
2012
Author(s)
Liu, Shu-Yuan
Abstract
Cancer has been the first leading cause of death for the past 30 years in Taiwan. Survival is one of the most concerned issues for patients and their families. Literature has suggested that handgrip strength might be an important prognostic factor for mortality, especially in the elderly, but clinical data are limited.
The purpose of this study was to examine the predictive power of handgrip strength in the elderly cancer population. As part of a trial study evaluating the effect of a nursing intervention on postsurgical functional decline, 95 elderly cancer patients (≧65 years) who were diagnosed with gastric and pancreatic cancer and scheduled for an abdominal surgery were enrolled from August 2007 to April 2009. Their handgrip strengths were taken prospectively at three time points: admission (preoperative baseline), discharge, and three-month after discharge. Whether handgrip strength is a prognostic factor for survival were analyzed using Cox Regression with cancer staging severed as a covariate.
The results shown that for every 1 kg increase in preoperative handgrip strength, the all-cause mortality decreased approximately 5% (95% confidence interval 0.90 to 0.99; P<.05). This result was independent of age, gender, cancer staging, cancer types, body mass index, comorbidity, medication taken, and whether an inpatient nursing intervention was received. The findings suggested that while cancer staging remains to be the strongest prognostic factor, the preoperative handgrip strength is an independent prognostic factor for all-cause survival in the elderly cancer patients with diagnoses of gastric and pancreatic cancer. If verified, handgrip strength measure will be a simple, yet effective parameter that is clinically accessible to predict survival so treatment decisions can be well-informed and justified.
Subjects
Elderly
cancer
handgrip
cancer staging
prognostic factor for survival
SDGs
Type
thesis
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