Usefulness of eight screening tools for predicting frailty and postoperative short- and long-term outcomes among older patients with cancer who qualify for abdominal surgery. Issue 11 (November 2020)

• Record Type: Journal Article
• Authors: Kenig, Jakub; Szabat, Kinga; Mituś, Jerzy; Mituś-Kenig, Maria; Krzeszowiak, Jerzy
• Is Part Of: European journal of surgical oncology. Volume 46:Issue 11(2020)
• Page Start: 2091
• Page End: 2098
• Publication Date: 2020-11
• Subjects: Geriatric assessment -- Frailty screening -- Surgery in the older -- Elderly; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2020.07.040
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Introduction: The aim of this study was to compare the ability of eight frailty screening scores to predict short- (30-day major morbidity and mortality), long-term outcomes (12-month mortality) and to compare their accuracy for predicting frailty among older patients with cancer undergoing elective abdominal surgery with curative intent. Materials and methods: Consecutive patients aged ≥70 years were enrolled prospectively. The diagnostic performance of eight screening tests were evaluated: The Vulnerable Elderly Survey (VES-13), Triage Risk Screening Tool (TRST), Geriatric 8 (G8), Groningen Frailty Index (GFI), abbreviated Comprehensive Geriatric Assessment (aCGA), Rockwood, Balducci and Fried score. Frailty was defined based on the Geriatric Assessment (GA) with two (2ID) or three impaired domains (3ID). Results: The study included 269 consecutive patients; median age 78 (range 70–94) years. The prevalence of frailty based on the reference GA was: 40.9% (2ID), 34.2% (3ID) and using screening tools 40–75.5%. The area under the curve (AUC) for predicting the postoperative outcome was: 0.58–0.75 (30-day morbidity), 0.54–0.71 (30-day mortality) and 0.59–0.74 (12-month mortality), respectively, being the highest for the G8. The AUC for the frailty screening tests was: 0.67–0.85 (at the 2ID) and 0.63–0.83 (at the 3ID), being the highest for the aCGA. Conclusion: The G8 was the best predictor of 30-day major morbidity, 30-day and 12-month mortality. It also had the highest sensitivity and negative predictive value in frailty screening, in case of both frailty definitions. In turn, the aCGA had the highest discriminatory ability in terms of frailty screening.