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Development and validation of a prognostic index for fracture risk in older men undergoing prostate cancer treatment.

ABSTRACT: Men treated with androgen deprivation therapy (ADT) or radiation therapy (RT) for prostate cancer have an increased risk for fractures. Given uncertainty as to whether specific clinical factors can identify men at increased risk, we sought to develop a prognostic index for risk of fracture in this population.We used the Surveillance, Epidemiology, and End Results-Medicare database to identify men who received ADT or RT after being diagnosed with localized prostate cancer in 2007-2009. Cox proportional hazards models tested the association of potential risk factors with fracture. In a derivation group, hazard ratios were used to assign points for factors independently related to fracture. The prognostic index was then applied to a validation group.The sample of 5824 men had a median age of 73.0 years; 82.9% were white and 8.6% had a fracture within 2 years of treatment for prostate cancer. The Cox model identified 8 variables (age, race, hormone treatment, Elixhauser score, anxiety, Parkinson's, fall-inducing medications and disability status) independently associated with fracture. In the derivation cohort, 4.3% of the sample experienced a fracture in the low-risk group, 8.9% in the intermediate group, and 19.2% in the high-risk group (C statistic, 0.749). The index was applied to the validation cohort (C statistic, 0.782).The prognostic index can help to identify patients at increased risk for fracture. This underscores the importance of identifying risk factors for fracture, given the substantial variation in fracture risk in men treated with ADT or RT.

SUBMITTER: Graham-Steed TR

PROVIDER: S-EPMC4252659 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Development and validation of a prognostic index for fracture risk in older men undergoing prostate cancer treatment.

Graham-Steed Tisheeka R TR Soulos Pamela R PR Dearing Natalie N Concato John J Tinetti Mary E ME Gross Cary P CP

Journal of geriatric oncology 20140918 4

<h4>Objectives</h4>Men treated with androgen deprivation therapy (ADT) or radiation therapy (RT) for prostate cancer have an increased risk for fractures. Given uncertainty as to whether specific clinical factors can identify men at increased risk, we sought to develop a prognostic index for risk of fracture in this population.<h4>Materials and methods</h4>We used the Surveillance, Epidemiology, and End Results-Medicare database to identify men who received ADT or RT after being diagnosed with l ...[more]

PMID: 25240918

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Project description:Background The ability to take care of oneself after hip fracture surgery is important for older adults. Various scales have been developed for evaluation of this ability, but a scale specifically focusing on hip fracture has not been developed. The aim of this study was to develop and validate a scale (Hip Fracture Surgery Self-Care Scale, HFS-SC) to evaluate self-care for older adults undergoing hip fracture surgery. Methods The scale was developed according to the guidelines by DeVellis. Initial items were derived from a literature review and individual interviews with 11 older adults who underwent hip fracture surgery. To confirm the suitability of the questions, a preliminary survey was conducted on 25 older adults. Psychometric testing was performed on 300 older adults 65 years old or over living at home after surgery for hip fracture. Psychometric properties of the scale were examined by content validity, construct validity, concurrent validity, internal consistency reliability, and test-retest reliability. Results Exploratory factor analysis and confirmatory factor analysis demonstrated that the 18-item scale comprised five factors (functional independence, symptom recognition and management, positive mental health, participation and support in social activities, and a safe environment). The results of EFA showed that the factor loadings ranging from 0.51 to 0.87. The results of CFA were χ2=375.83, χ2/df=2.14, RMSEA 0.07, SRMR 0.05, GFI 0.88, TLI 0.91, and CFI 0.92 for the 18-item scale. The reliabilities of the scale were 0.91 for Cronbach’s alpha and 0.82 for test-retest reliability. Conclusions The HFS-SC has acceptable validity and reliability and is expected to be useful for evaluating the levels of self-care for older adults undergoing hip fracture surgery and adjusting at the post-fracture period at the community or out-patient department. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00982-3.

Dataset Information

Development and validation of a prognostic index for fracture risk in older men undergoing prostate cancer treatment.

Publications

Development and validation of a prognostic index for fracture risk in older men undergoing prostate cancer treatment.

Similar Datasets

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