Elderly patients with Cancer, global assesment. Results of Nursing evaluation

Abstract

Introduction: It is a fact that cancer is an aging associated disease. For years we have seen how the population pyramid has beem growing old. Half of the firs visits that we see in our service per year are over 65 years, Each person has a different biological and functional status despite having the same chronological age, and this is what makes them tolerate differently oncological treatments. This is reason why we need a specific assessment of olfer patients to help us make decisions and act accordingly. Objetives: Study and analyze the results obtained in the fragility screening performed at first nursing visit in our service in patients over 75 years Methods: In 2017 we started to make a first nursing visit to all patients in which a fragility screening was performed in patients over 75. In this first visit we´ve been collecting data and making different scales of the patients, such as: Tumour and Patient´s data Nutritional status (Malnutritional screening tool MST) Emocional and socio-family status (Gijon scale) Functional status (Barthel) Cognitive status (Pfeiffer) Fragility screening (G8) A database was created to collect all the information Results: Throughout the 10 months 139 patients older than 75 years were collected. Of these, 50.7 were women and 49.3% men ; with a median age of 79 years. In order of incidence, the most frequent tumors were : breast, gastrointestinal, lung and genitourinary cancer; and of all these, 50.3% debuted in stage IV. The median of comorbidities (Charlson scale) were 2. The performance status of our patients , measured by the Eastern Cooperative Oncology Group scale (ECOG), of all the patients collected the ECOG distribution was: 36.4% ECOG 1, 43.4% ECOG 2, 16.2%ECOG 3 and 4% ECOG 4. 72.9% of the patients received some kind of antineoplasic treatment ( 65.5 chemotherapy, 26.2 %hormone therapy, 7.1 % targeted therapy and 1.2% immunotherapy) of all of them in 89.1% of the cases it was given at a full dose and in the remaining 10.9 % with a dose reduction. Emotional discomfort measured according to the visual analog scale (VAS) with a median of 5. As far as nutritional status is concerned, the median of weight of the patients was 26 kg with a median of BMI OF 26. The MST scale reflected that 36.1% were at risk of malnutrition, being the most frequent Digestive symptomatology constipation, anorexy, diarrhea and abdominal pain. As for the screening, we see that 25.5% of the patients we see are dependent having a <90 in Barthel scale . Cognitive impairment was shown in a 15.4 % (Pfeiffer test) and finally to 22.3% of them appeared altered the G8, being the currently most recognized tool in elderly oncology patients Conclusions: Geriatric assessment by a specialized nursing team is a useful tool to make a correct evaluation. It allows detecting areas of vulnerability to be able to act on them and correct them. All with the aim of improving the care of elderly patients with cancer.

Keywords

• elder frailty cancer globlal assessment