肿瘤患者衰弱影响因素的meta分析
ssociated Factors of frailty in cancer patients: a Meta-analysis
背景 衰弱在肿瘤患者中高发，严重影响患者的预后恢复。 目的 通过Meta分析明确肿瘤患者衰弱影响因素，为后期肿瘤患者衰弱干预方案的设计及实施提供科学依据。方法 全面系统检索从建库至 2022 年 8 月中国知网、维普、万方、PubMed、Web of Science、Cochrane Library 、CINAHL、Embase数据库，纳入关于肿瘤患者衰弱影响因素的研究。筛选文献，对符合纳排标准的文献进行质量评价、数据提取，采用Stata17.0和RevMan 5.4 软件进行 Meta 分析。结果 共纳入 11篇文献，其中 9篇横断面研究，2篇队列研究，包括 2898 例肿瘤患者，其中衰弱患者1025例，涉及影响因素12个。Meta 分析结果显示，肿瘤患者衰弱的平均发生率为34%，其影响因素为年龄〔OR=1.16，95%CI（1.05，1.27），P=0.002〕、文化程度〔OR=0.78，95%CI（0.68，0.90），P=0.003〕、合并其他疾病〔OR=1.46，95%CI（1.28，1.67），P<0.001〕、身体质量指数（BMI）〔OR=1.13，95%CI（1.05，1.21），P<0.001〕、白蛋白〔OR=0.33，95%CI（0.12，0.90），P=0.03〕、营养状况〔OR=2.77，95%CI（1.27，6.06），P=0.01〕、症状群〔OR=1.07，95%CI（1.04，1.09），P<0.001〕，抑郁〔OR=1.27，95%CI（1.12，1.44），P<0.001〕、工具性日常生活活动能力（IADL）〔OR=0.50，95%CI（0.42，0.59），P<0.001〕，而性别〔OR=0.81，95%CI（0.54，1.21），P=0.30〕、婚姻状况〔OR=0.21，95%CI（0.02，2.31），P=0.20〕以及血红蛋白〔OR=0.51，95%CI（0.22，1.22），P=0.13〕与肿瘤患者衰弱无关。结论 现有meta结果表明年龄、文化程度、合并其他疾病、BMI、白蛋白、营养状况、症状群、抑郁、IADL是肿瘤患者发生衰弱的影响因素。高龄、文化程度低、合并及其疾病、BMI高、白蛋白水平＜35 g/L，营养状况差、伴有症状群、有抑郁情绪以及日常生活活动能力低下的肿瘤患者是我们需要关注的重点人群。
BackgroundFrailty is common in cancer patients, which seriously affects the prognosis of patients. ObjectiveTo identify the factors associated with frailty in cancer patients by meta-analysis, and to provide scientific basis for the design and implementation of frailty intervention program of frailty in cancer patients. MethodsThe databases of China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Wanfang, PubMed, Web of Science, Cochrane Library, CINAHL and Embase were searched to collect the studies on the associated factors of frailty in cancer patients from the inception to August 2022. A meta-analysis on the included literature was performed by using Stata 17.0 and RevMan 5.4. ResultsA total of 11 articles were included, including 9 cross-sectional studies and 2 cohort studies, including 2898 cancer patients, including 1025 frailty patients, involving 12 associated factors. The results of meta-analysis showed that the average incidence of frailty in cancer patients was 34%, and the associated factors were age [OR=1.16, 95%CI (1.05, 1.27), P<0.001], educational level [OR=0.78, 95%CI (0.68, 0.90)], comorbidity [OR=1.46, 95%CI (1.28, 1.67), P<0.001], body mass index (BMI) [OR=1.13, 95%CI (1.05, 1.21), P<0.001], albumin [OR=0.33, 95%CI (0.12, 0.90), P=0.03], nutritional status [OR=2.77, 95%CI (1.27, 6.06), P=0.01], syndrome group [OR=1.0795%CI1.041.09P<0.001]depression [OR=1.27, 95%CI (1.12, 1.44), P<0.001], instrumental activities of daily life (IADL) [OR=0.50, 95%CI (0.42, 0.59), P<0.001), while gender [OR=0.81, 95%CI (0.54, 1.21), P=0.30], marital status [OR=0.21, 95%CI (0.02, 2.31), P=0.20] and hemoglobin [OR=0.51, 95%CI (0.22, 1.22), P=0.13] was not related to the frailty of cancer patients. ConclusionThe available research evidence suggests that age, education level, comorbidity, BMI, albumin, nutritional status, syndrome group, depression and IADL are the associated factors of frailty in cancer patients. Cancer patients with advanced age, low education level, combined with other diseases, High BMI, albumin level < 35 g/L, poor nutritional status, with symptoms group, depression and low activities of daily living are the priority population we need to pay attention to.
缪雪怡、许勤、徐婷、蒋小曼、郭银宁
肿瘤学医学研究方法
肿瘤衰弱影响因素Meta分析
缪雪怡,许勤,徐婷,蒋小曼,郭银宁.肿瘤患者衰弱影响因素的meta分析[EB/OL].(2022-11-16)[2025-08-02].https://chinaxiv.org/abs/202211.00223.点此复制
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