Adverse Events beim Training mit onkologischen Patienten: Wie sicher ist das Training außerhalb klinischer Studien?

Zusammenfassung

Über das Auftreten von Zwischenfällen, sogenannten Adverse Events, im Training mit onkologischen Patienten liegen bislang nur wenige Daten vor. Diese wurden im Rahmen von klinischen Studien erfasst und beschreiben das Training als sicher. Ziel der vorliegenden Arbeit war es, die Sicherheit von Training mit onkologischen Patienten in der Routineversorgung zu erfassen.

Mithilfe eines selbstentwickelten Fragebogens wurden retrospektiv für das Jahr 2017 Trainingszentren befragt, wie häufig Serious Adverse Events (Tod, reanimationspflichtiger Herzkreislaufstillstand, Knochenbrüche, Narbenbrüche, Verletzungen) und Non-Serious Adverse Events (Krampfanfälle, Übelkeit / Erbrechen, muskuläre Beschwerden, Kreislaufbeschwerden, oberflächliche Wunden / Hämatome) während des Trainings mit onkologischen Patienten aufgetreten waren.

Es konnten 34 Fragebögen aus 12 Ländern ausgewertet werden. In insgesamt 91.252 Patientenstunden traten 672 Adverse Events auf. Davon wurden 10 Zwischenfälle als Serious Adverse Events bewertet (Inzidenz 11 pro 100.000 Patientenstunden), wobei keine Todesfälle darunter waren. Die meisten (n = 6) Serious Adverse Events traten während des Ausdauertrainings auf. Als Non-Serious Adverse Events wurden 662 Zwischenfälle angegeben (Inzidenz 725 pro 100.000 Patientenstunden). Non-Serious Adverse Events wurden auf alle Trainingsarten verteilt beobachtet.

Training mit onkologischen Patienten in der Routineversorgung außerhalb von Studien kann vorläufig als sicher bewertet werden, da die vorliegende erste Erhebung in über 90.000 Patientenstunden keinen Todesfall ergab. Allerdings sollten Sporttherapeuten auf Zwischenfälle vorbereitet sein und Ausdauertraining besonders aufmerksam betreuen.

Summary

Only little data is available on the incidence of adverse events during exercise training in cancer patients. Those data sets which are available were collected in clinical trials and describe the training as safe. Therefore, the aim of the present study was to assess safety of training with cancer patients in routine care under real world circumstances. Using a self-developed questionnaire, training centers were asked retrospectively how many serious adverse events (death, cardiac arrest requiring resuscitation, bone fractures, incisional hernia, injuries) and non-serious adverse events (seizures, nausea / vomiting, muscular complaints, circulatory complaints, superficial wounds / hematomas) had occurred during training with cancer patients in 2017. Thirty-four questionnaires from 12 countries could be evaluated. In a total of 91,252 patient hours, 672 adverse events occurred. Of these, 10 were serious adverse events (incidence 11 per 100,000 patient hours) but no death was reported. Most serious adverse events (n = 6) occurred during endurance training. 662 were non-serious adverse events (incidence 725 per 100,000 patient hours). Non-serious adverse events were distributed over all training types. This first evaluation revealed that training with cancer patients outside of studies in routine care is relatively safe because no death occurred in more than 90,000 patient hours. However, exercise therapists should be prepared for adverse events. Moreover, our data suggest that endurance training interventions are more likely to be affected by adverse events than other exercise settings.

Stichworte

Training - Krebs - Onkologie - Sicherheit - Zwischenfälle

Key words

Training - cancer - safety - adverse events

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