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Master Thesis

Évolution du statut fonctionnel et facteurs associes a la perte d’indépendance de patient âgés de 75 ans et plus, pris en charge pour un cancer urologique, digestif ou pulmonaire

Abstract : Objective: the objective of our study was to investigate the factors associated with loss of independence of patients aged 75 years and older, carried out for urological, digestive or bronchial cancer. We also studied the evolution of their functional status, regardless of their oncological treatment. Material And Method: patients who received a geriatric consultation at the Bordeaux University Hospital at the time of diagnosis of their cancer were included in our study. A retrospective collection of sociodemographic, clinical, geriatric and oncological characteristics was produced from the consultation letters. A telephone follow-up was carried out at a distance from the initial assessment, allowing the collection of their functional status and their way of life. Functional decline (FD) was defined as the loss of one point on ADL (score / 6) between the two assessments. The geriatric and oncological data from the initial consultation were examined to see if they were factors independent of functional decline. Results: 179 patients of median age close to 83 years were analyzed. Of these, 31% were initially dependent on LDAs. At follow-up, ADL and IADL of 90 patients were available (50%). FD on ADL was observed for 33% of patients. In multivariate analysis, factors independent of FD were cognitive impairment (OR: 12.6, CI [2.1-74.4], p = 0.005), failure to maintain unipodal support (CR : 3.9, IC [1.0-14.7], p = 0.04) and the presence of a home-based FDI at the beginning of management (CR: 11.5, CI [1.9- 68.1], p = 0.007). Conclusion: the FD during cancer is common, it concerns a third of patients. The absence or on the contrary the realization of an oncological treatment (whatever it is) are not significantly associated with the DF. Geriatric data, such as initial dependence, cognitive or locomotor disorders, are independent factors of FD. They are easily identifiable at the beginning of care and would allow to put in place adapted measures to prevent or delay FD.
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Master Thesis
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Submitted on : Saturday, February 29, 2020 - 11:47:46 AM
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Marion Fiquet. Évolution du statut fonctionnel et facteurs associes a la perte d’indépendance de patient âgés de 75 ans et plus, pris en charge pour un cancer urologique, digestif ou pulmonaire. Médecine humaine et pathologie. 2019. ⟨dumas-02494753⟩

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