Abstract
BackgroundMultimorbidity is highly prevalent in older adults, both those with and without cancer, and is associated with an increased risk of mortality. The aim of this study was to investigate if multimorbidity measures in geriatric rehabilitation inpatients differ in their association with mortality, dependent on a diagnosis of cancer.MethodsREStORing health of acutely unwell adulTs (RESORT) is an ongoing longitudinal inception cohort of geriatric rehabilitation inpatients. Comorbidity was measured at admission using the Charlson Comorbidity Index (CCI), age-adjusted CCI (CCI-A), Cumulative Illness Rating Scale–Geriatrics (CIRS-G) and the CIRS-G severity index. Patients were allocated to a cancer status group (no cancer, history of cancer, or active cancer). The association of comorbidity indices with mortality was analyzed using Cox regression analyses.ResultsOf the 693 patients (mean age 82.2 ± 7.5 years), 523 (75.4%) had no history of cancer, 96 (13.9%) past cancer, and 74 (10.7%) active cancer. Three months post-discharge, patients with active cancer had a higher mortality risk compared to patients with no cancer (HR = 3.57, 95% CI 2.03–6.23). CCI and CCI-A scores were significantly associated with higher mortality risk in all cancer status groups.ConclusionIn geriatric rehabilitation patients, incremental CCI and CCI-A scores were associated with higher mortality in all three cancer status groups. However, patients with active cancer had a significantly higher 3-month mortality compared to those with no or past cancer, and this is likely determined by the advanced nature of the malignancies in this group.
Highlights
Cancer is a leading cause of disease burden and mortality worldwide, and the majority of diagnoses are made in individuals aged 65 years or older [1, 2]
[3] and oncological populations [4]. It may be measured using a number of validated assessment tools, the Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale–Geriatric (CIRS-G) version being two of the most commonly utilized [5]
Higher comorbidity scores are associated with higher mortality risk [6], but this varies according to cancer type and stage [7], having less impact in those with advanced or rapidly proliferating cancers [7]
Summary
Cancer is a leading cause of disease burden and mortality worldwide, and the majority of diagnoses are made in individuals aged 65 years or older [1, 2]. [3] and oncological populations [4] It may be measured using a number of validated assessment tools, the Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale–Geriatric (CIRS-G) version being two of the most commonly utilized [5]. In the context of higher life expectancy and the expanding treatment options for older patients diagnosed with cancer, it is likely that an increasing. Multimorbidity is highly prevalent in older adults, both those with and without cancer, and is associated with an increased risk of mortality. The aim of this study was to investigate if multimorbidity measures in geriatric rehabilitation inpatients differ in their association with mortality, dependent on a diagnosis of cancer. CCI and CCI-A scores were significantly associated with higher mortality risk in all cancer status groups
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