A model for the functional assessment of elderly with myeloid neoplasms
Objective: Myeloid neoplasms are heterogeneous diseases that are more incident in the elderly. The goals of this study were to aggregate a geriatric approach to the patient assessment, to show the impact of gender, age, hemoglobin concentration and comorbidities on the functionality of elderly with...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-04-01
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| Series: | Revista Brasileira de Hematologia e Hemoterapia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000200109&lng=en&tlng=en |
| _version_ | 1818305813058420736 |
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| author | Ana Lúcia Ippolito Carbonell Renata Maceu Salhab Viviana Giampaoli Maysa Seabra Cendoroglo Maria de Lourdes Chauffaille |
| author_facet | Ana Lúcia Ippolito Carbonell Renata Maceu Salhab Viviana Giampaoli Maysa Seabra Cendoroglo Maria de Lourdes Chauffaille |
| author_sort | Ana Lúcia Ippolito Carbonell |
| collection | DOAJ |
| description | Objective: Myeloid neoplasms are heterogeneous diseases that are more incident in the elderly. The goals of this study were to aggregate a geriatric approach to the patient assessment, to show the impact of gender, age, hemoglobin concentration and comorbidities on the functionality of elderly with myeloid neoplasms and to better understand how the instruments of functional assessment work according to the aggressiveness of the disease. Methods: Elderly patients (≥60 years old) with myeloid neoplasms were assessed using the Karnofsky scale, Eastern Cooperative Oncologic Group scale, and basic and instru- mental activities of daily living scales. The hematopoietic cell transplantation-comorbidity index assessed the comorbidities. A mixed logistical regression model was fitted to estimate the impact of gender, age, hemoglobin concentration and the hematopoietic cell transplantation-comorbidity index on patients' functionality. Results: Eighty-two patients with a mean age of 72.8 years (range: 60-92 years) were evaluated. Eighty percent had good Karnofsky and Eastern Cooperative Oncologic Group scales and 39% were independent according to the daily living activity scales. All of the patients with poor Karnofsky and Eastern Cooperative Oncologic Group scales were classified as dependent by the daily living activity scales. The mixed logistic regression models showed that age, gender, hemoglobin concentration and the comorbidity index impacted on the daily living activity scales. Karnofsky and Eastern Cooperative Oncologic Group scales were affected by hemoglobin and the comorbidity index. The model hypothesized the hemoglobin concentration at which there was a higher risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales. This hemoglobin concentration depended on comorbidities and on the aggressiveness of the myeloid neoplasm. Conclusion: The geriatric approach improved the sensitivity and specificity of the patients' assessment. Hemoglobin concentration associated to the risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales depended on the comorbidity score and on the disease aggressiveness. The Karnofsky and Eastern Cooperative Oncologic Group scales had higher sensitivity in patients with more aggressive diseases. |
| first_indexed | 2024-12-13T06:32:33Z |
| format | Article |
| id | doaj.art-ecc745a4967f4de097439413c5b22cf6 |
| institution | Directory Open Access Journal |
| issn | 1806-0870 |
| language | English |
| last_indexed | 2024-12-13T06:32:33Z |
| publishDate | 2015-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista Brasileira de Hematologia e Hemoterapia |
| spelling | doaj.art-ecc745a4967f4de097439413c5b22cf62022-12-21T23:56:35ZengElsevierRevista Brasileira de Hematologia e Hemoterapia1806-08702015-04-0137210911410.1016/j.bjhh.2015.02.003S1516-84842015000200109A model for the functional assessment of elderly with myeloid neoplasmsAna Lúcia Ippolito CarbonellRenata Maceu SalhabViviana GiampaoliMaysa Seabra CendorogloMaria de Lourdes ChauffailleObjective: Myeloid neoplasms are heterogeneous diseases that are more incident in the elderly. The goals of this study were to aggregate a geriatric approach to the patient assessment, to show the impact of gender, age, hemoglobin concentration and comorbidities on the functionality of elderly with myeloid neoplasms and to better understand how the instruments of functional assessment work according to the aggressiveness of the disease. Methods: Elderly patients (≥60 years old) with myeloid neoplasms were assessed using the Karnofsky scale, Eastern Cooperative Oncologic Group scale, and basic and instru- mental activities of daily living scales. The hematopoietic cell transplantation-comorbidity index assessed the comorbidities. A mixed logistical regression model was fitted to estimate the impact of gender, age, hemoglobin concentration and the hematopoietic cell transplantation-comorbidity index on patients' functionality. Results: Eighty-two patients with a mean age of 72.8 years (range: 60-92 years) were evaluated. Eighty percent had good Karnofsky and Eastern Cooperative Oncologic Group scales and 39% were independent according to the daily living activity scales. All of the patients with poor Karnofsky and Eastern Cooperative Oncologic Group scales were classified as dependent by the daily living activity scales. The mixed logistic regression models showed that age, gender, hemoglobin concentration and the comorbidity index impacted on the daily living activity scales. Karnofsky and Eastern Cooperative Oncologic Group scales were affected by hemoglobin and the comorbidity index. The model hypothesized the hemoglobin concentration at which there was a higher risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales. This hemoglobin concentration depended on comorbidities and on the aggressiveness of the myeloid neoplasm. Conclusion: The geriatric approach improved the sensitivity and specificity of the patients' assessment. Hemoglobin concentration associated to the risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales depended on the comorbidity score and on the disease aggressiveness. The Karnofsky and Eastern Cooperative Oncologic Group scales had higher sensitivity in patients with more aggressive diseases.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000200109&lng=en&tlng=enPerformance testsKarnofsky performance statusAgedLeukemiamyeloidMyelodysplastic-myeloproliferative diseases |
| spellingShingle | Ana Lúcia Ippolito Carbonell Renata Maceu Salhab Viviana Giampaoli Maysa Seabra Cendoroglo Maria de Lourdes Chauffaille A model for the functional assessment of elderly with myeloid neoplasms Revista Brasileira de Hematologia e Hemoterapia Performance tests Karnofsky performance status Aged Leukemia myeloid Myelodysplastic-myeloproliferative diseases |
| title | A model for the functional assessment of elderly with myeloid neoplasms |
| title_full | A model for the functional assessment of elderly with myeloid neoplasms |
| title_fullStr | A model for the functional assessment of elderly with myeloid neoplasms |
| title_full_unstemmed | A model for the functional assessment of elderly with myeloid neoplasms |
| title_short | A model for the functional assessment of elderly with myeloid neoplasms |
| title_sort | model for the functional assessment of elderly with myeloid neoplasms |
| topic | Performance tests Karnofsky performance status Aged Leukemia myeloid Myelodysplastic-myeloproliferative diseases |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000200109&lng=en&tlng=en |
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