Preoperative frailty is a risk factor for non-home discharge in patients undergoing surgery for endometrial cancer. Issue 5 (September 2018)

• Record Type: Journal Article
• Authors: Adedayo, Pelumi; Resnick, Kimberly; Singh, Sareena
• Is Part Of: Journal of geriatric oncology. Volume 9:Issue 5(2018)
• Page Start: 513
• Page End: 515
• Publication Date: 2018-09
• Subjects: NSQIP -- Non-home discharge -- Endometrial cancer -- Frailty; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2018.02.005
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Objective: Our objective was to examine the association of the modified frailty index (mFI) and non-home discharge in patients undergoing surgery for endometrial cancer (EMCA). Methods: Patients who underwent surgery for EMCA from 2011 to 2012 were identified from the American College of Surgeons - Nastional Surigical Quality Improvement Project (ACS-NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify surgical characteristics. We excluded patients who were already living in a non-home facility. To determine frailty, we used the NSQIP frailty index. For analysis purposes, patients with an mFI score ≥0.18 were defined as frail. Patients were divided into groups based on discharge destination. Logistic regression were used to identify predictors of post-operative non-home discharge. Results: 1216 patients were identified. 26 (2.1%) were discharged to a non-home facility. On multivariate analysis, patients who were discharged to a non-home facility were older (OR 1.09, 95% CI 1.04–1.14, p < 0.001), had a higher Body Mass Index (BMI) (OR 1.08, 95% CI 1.04–1.12, p < 0.001), were more likely to have disseminated cancer (OR 10.02, 95% CI 2.28–44.1, p = 0.002), and were frail (OR 1.95, 95% CI 1.91–5.01, p = 0.008). Undergoing minimally-invasive surgery was independently associated with discharge to home (OR 0.165, 95% CI 0.059–0.458, p = 0.001). Conclusion: Frailty is associated with increased risk of non-home discharge in patients undergoing surgery for EMCA. The mFI can be easily calculated using patient characteristics that are readily available pre-operatively. This information can be used for pre-op counseling and to facilitate appropriate and timely discharge planning.