Fatores preditores para óbito precoce identificados pela avaliação geriátrica ampla em pacientes com tumores digestivos: um estudo de coorte prospectiva

Abstract

Objectives: To determine the predictive factors for early death, the one that occurred within 6 months of follow-up of the cohort, in cancer patients with gastrointestinal tumors. Methods: Prospective cohort study involving the elderly (≥ 60 years) diagnosed with cancer of the gastrointestinal tract, admitted from January 2015 to February 2020. At the time of admission, socio-demographic, clinical and 12 tests were evaluated that make up the Comprehensive Geriatric Assessment (CGA). The follow-up period was six months and the outcome studied was death. Descriptive analysis, survival study using the Kaplan-Meier method and multivariate analysis of Cox proportional hazards were recorded. Results: 513 were included in the study. 49.5% progressed to death within 6 months of admission. The most relevant predictive factors for death identified by the CGA were Mini Global Nutritional Assessment (MNA) ≤ 23.5 (HR 2.08 CI 95% 1.54- 2.82), Timed Up And Go - Mobility for patients with medium, moderate and severe abnormality (HR 1.54 95% CI 1.11-2.14) and the Palliative Performance Scale (PPS) ≤ 50 (HR 2.10 95% CI 1.48–2.98). Shorter survival occurred among patients with altered scales at admission (log rank <0.001). Conclusion: Early death was a highly prevalent outcome in the population studied. The abnormal status of MAN, PPS and TUG - mobility were identified as predictors of this early death. These tests are easy to apply and are recommended as part of the AGA performed for initial assessment and planning of comprehensive care to be offered.