Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer
Abstract Background Maintaining the ability to perform self‐care is a critical goal in patients with cancer. We assessed whether the patient‐reported ability to walk 4 m and wash oneself predict survival in patients with pre‐terminal cancer. Methods We performed a prospective observational study on...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-08-01
|
| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.13247 |
| _version_ | 1797754728842526720 |
|---|---|
| author | Markus S. Anker Alessia Lena Eric J. Roeland Jan Porthun Sebastian Schmitz Sara Hadzibegovic Philipp Sikorski Ursula Wilkenshoff Ann‐Kathrin Fröhlich Luisa Valentina Ramer Matthias Rose Jan Eucker Tienush Rassaf Matthias Totzeck Lorenz H. Lehmann Stephan vonHaehling Andrew J.S. Coats Tim Friede Javed Butler Stefan D. Anker Hanno Riess Ulf Landmesser Lars Bullinger Ulrich Keller Johann Ahn |
| author_facet | Markus S. Anker Alessia Lena Eric J. Roeland Jan Porthun Sebastian Schmitz Sara Hadzibegovic Philipp Sikorski Ursula Wilkenshoff Ann‐Kathrin Fröhlich Luisa Valentina Ramer Matthias Rose Jan Eucker Tienush Rassaf Matthias Totzeck Lorenz H. Lehmann Stephan vonHaehling Andrew J.S. Coats Tim Friede Javed Butler Stefan D. Anker Hanno Riess Ulf Landmesser Lars Bullinger Ulrich Keller Johann Ahn |
| author_sort | Markus S. Anker |
| collection | DOAJ |
| description | Abstract Background Maintaining the ability to perform self‐care is a critical goal in patients with cancer. We assessed whether the patient‐reported ability to walk 4 m and wash oneself predict survival in patients with pre‐terminal cancer. Methods We performed a prospective observational study on 169 consecutive hospitalized patients with cancer (52% female, 64 ± 12 years) and an estimated 1–12 months prognosis at an academic, inpatient palliative care unit. Patients answered functional questions for ‘today’, ‘last week’, and ‘last month’, performed patient‐reported outcomes (PROs), and physical function assessments. Results Ninety‐two (54%) patients reported the ability to independently walk 4 m and 100 (59%) to wash ‘today’. The median number of days patients reported the ability to walk 4 m and wash were 6 (IQR 0–7) and 7 (0–7) days (‘last week’); and 27 (5–30) and 26 (10–30) days (‘last month’). In the last week, 32% of patients were unable to walk 4 m on every day and 10% could walk on 1–3 days; 30% were unable to wash on every day and 10% could wash on 1–3 days. In the last months, 14% of patients were unable to walk 4 m on every day and 10% could only walk on 1–10 days; 12% were unable to wash on every day and 11% could wash on 1–10 days. In patients who could walk ‘today’ average 4 m gait speed was 0.78 ± 0.28 m/s. Patients who reported impaired walking and washing experienced more symptoms (dyspnoea, exertion, and oedema) and decreased physical function (higher Eastern Cooperative Oncology Group Performance Status, and lower Karnofsky Performance Status and hand‐grip strength [unable vs. able to walk ‘today’: 205 ± 87 vs. 252 ± 78 Newton, P = 0.001; unable vs. able to wash ‘today’: 204 ± 86 vs. 250 ± 80 Newton, P = 0.001]). During the 27 months of observation, 152 (90%) patients died (median survival 46 days). In multivariable Cox proportional hazards regression analyses, all tested parameters were independent predictors of survival: walking 4 m ‘today’ (HR 0.63, P = 0.015), ‘last week’ (per 1 day: HR 0.93, P = 0.011), ‘last month’ (per 1 day: HR 0.98, P = 0.012), 4 m gait speed (per 1 m/s: HR 0.45, P = 0.002), and washing ‘today’ (HR 0.67, P = 0.024), ‘last week (per 1 day HR 0.94, p=0.019), and ‘last month’ (per 1 day HR 0.99, P = 0.040). Patients unable to walk and wash experienced the shortest survival and most reduced functional status. Conclusions In patients with pre‐terminal cancer, the self‐reported ability to walk 4 m and wash were independent predictors of survival and associated with decreased functional status. |
| first_indexed | 2024-03-12T17:36:50Z |
| format | Article |
| id | doaj.art-82004b66f10346b7a6c7d5d527c6beba |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-03-12T17:36:50Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-82004b66f10346b7a6c7d5d527c6beba2023-08-04T10:07:00ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092023-08-011441670168110.1002/jcsm.13247Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancerMarkus S. Anker0Alessia Lena1Eric J. Roeland2Jan Porthun3Sebastian Schmitz4Sara Hadzibegovic5Philipp Sikorski6Ursula Wilkenshoff7Ann‐Kathrin Fröhlich8Luisa Valentina Ramer9Matthias Rose10Jan Eucker11Tienush Rassaf12Matthias Totzeck13Lorenz H. Lehmann14Stephan vonHaehling15Andrew J.S. Coats16Tim Friede17Javed Butler18Stefan D. Anker19Hanno Riess20Ulf Landmesser21Lars Bullinger22Ulrich Keller23Johann Ahn24Department of Cardiology, Angiology and Intensive Care Medicine CBF Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine CBF Deutsches Herzzentrum der Charité Berlin GermanyKnight Cancer Institute Oregon Health and Science University Portland Oregon USACharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine CBF Deutsches Herzzentrum der Charité Berlin GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine CBF Deutsches Herzzentrum der Charité Berlin GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDepartment of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt‐Universität zu Berlin Berlin GermanyDepartment of Hematology and Oncology Charité ‐ Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt‐Universität zu Berlin and Berlin Institute of Health, Campus Benjamin‐Franklin Berlin GermanyDepartment of Cardiology and Vascular Medicine, West German Heart and Vascular Center University Hospital Essen Essen GermanyDepartment of Cardiology and Vascular Medicine, West German Heart and Vascular Center University Hospital Essen Essen GermanyDepartment of Cardiology, Angiology, and Pneumology, Cardio‐Oncology Unit Heidelberg University Hospital Heidelberg GermanyDepartment of Cardiology and Pneumology University Medicine Goettingen (UMG) Goettingen GermanyHeart Research Institute Sydney AustraliaGerman Center for Cardiovascular Research (DZHK), partner site Göttingen Göttingen GermanyBaylor Scott and White Research Institute Dallas Texas USACharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDepartment of Hematology, Oncology, and Tumor Immunology Charité ‐ Universitätsmedizin Berlin, Campus CCM Berlin GermanyDepartment of Cardiology, Angiology and Intensive Care Medicine CBF Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Hematology, Oncology, and Tumor Immunology Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDepartment of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin Berlin GermanyDepartment of Hematology, Oncology, and Tumor Immunology Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyAbstract Background Maintaining the ability to perform self‐care is a critical goal in patients with cancer. We assessed whether the patient‐reported ability to walk 4 m and wash oneself predict survival in patients with pre‐terminal cancer. Methods We performed a prospective observational study on 169 consecutive hospitalized patients with cancer (52% female, 64 ± 12 years) and an estimated 1–12 months prognosis at an academic, inpatient palliative care unit. Patients answered functional questions for ‘today’, ‘last week’, and ‘last month’, performed patient‐reported outcomes (PROs), and physical function assessments. Results Ninety‐two (54%) patients reported the ability to independently walk 4 m and 100 (59%) to wash ‘today’. The median number of days patients reported the ability to walk 4 m and wash were 6 (IQR 0–7) and 7 (0–7) days (‘last week’); and 27 (5–30) and 26 (10–30) days (‘last month’). In the last week, 32% of patients were unable to walk 4 m on every day and 10% could walk on 1–3 days; 30% were unable to wash on every day and 10% could wash on 1–3 days. In the last months, 14% of patients were unable to walk 4 m on every day and 10% could only walk on 1–10 days; 12% were unable to wash on every day and 11% could wash on 1–10 days. In patients who could walk ‘today’ average 4 m gait speed was 0.78 ± 0.28 m/s. Patients who reported impaired walking and washing experienced more symptoms (dyspnoea, exertion, and oedema) and decreased physical function (higher Eastern Cooperative Oncology Group Performance Status, and lower Karnofsky Performance Status and hand‐grip strength [unable vs. able to walk ‘today’: 205 ± 87 vs. 252 ± 78 Newton, P = 0.001; unable vs. able to wash ‘today’: 204 ± 86 vs. 250 ± 80 Newton, P = 0.001]). During the 27 months of observation, 152 (90%) patients died (median survival 46 days). In multivariable Cox proportional hazards regression analyses, all tested parameters were independent predictors of survival: walking 4 m ‘today’ (HR 0.63, P = 0.015), ‘last week’ (per 1 day: HR 0.93, P = 0.011), ‘last month’ (per 1 day: HR 0.98, P = 0.012), 4 m gait speed (per 1 m/s: HR 0.45, P = 0.002), and washing ‘today’ (HR 0.67, P = 0.024), ‘last week (per 1 day HR 0.94, p=0.019), and ‘last month’ (per 1 day HR 0.99, P = 0.040). Patients unable to walk and wash experienced the shortest survival and most reduced functional status. Conclusions In patients with pre‐terminal cancer, the self‐reported ability to walk 4 m and wash were independent predictors of survival and associated with decreased functional status.https://doi.org/10.1002/jcsm.13247Self‐carePalliative careWalking abilityWashing abilityCancerIndependence |
| spellingShingle | Markus S. Anker Alessia Lena Eric J. Roeland Jan Porthun Sebastian Schmitz Sara Hadzibegovic Philipp Sikorski Ursula Wilkenshoff Ann‐Kathrin Fröhlich Luisa Valentina Ramer Matthias Rose Jan Eucker Tienush Rassaf Matthias Totzeck Lorenz H. Lehmann Stephan vonHaehling Andrew J.S. Coats Tim Friede Javed Butler Stefan D. Anker Hanno Riess Ulf Landmesser Lars Bullinger Ulrich Keller Johann Ahn Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer Journal of Cachexia, Sarcopenia and Muscle Self‐care Palliative care Walking ability Washing ability Cancer Independence |
| title | Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer |
| title_full | Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer |
| title_fullStr | Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer |
| title_full_unstemmed | Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer |
| title_short | Patient‐reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre‐terminal cancer |
| title_sort | patient reported ability to walk 4 m and to wash new clinical endpoints and predictors of survival in patients with pre terminal cancer |
| topic | Self‐care Palliative care Walking ability Washing ability Cancer Independence |
| url | https://doi.org/10.1002/jcsm.13247 |
| work_keys_str_mv | AT markussanker patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT alessialena patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT ericjroeland patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT janporthun patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT sebastianschmitz patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT sarahadzibegovic patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT philippsikorski patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT ursulawilkenshoff patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT annkathrinfrohlich patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT luisavalentinaramer patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT matthiasrose patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT janeucker patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT tienushrassaf patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT matthiastotzeck patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT lorenzhlehmann patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT stephanvonhaehling patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT andrewjscoats patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT timfriede patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT javedbutler patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT stefandanker patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT hannoriess patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT ulflandmesser patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT larsbullinger patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT ulrichkeller patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer AT johannahn patientreportedabilitytowalk4mandtowashnewclinicalendpointsandpredictorsofsurvivalinpatientswithpreterminalcancer |