Tomohiro F Nishijima1, Taito Esaki2, Masaru Morita3, Yasushi Toh4. 1. Geriatric Oncology Service, National Hospital Organization (NHO) Kyushu Cancer Center, Fukuoka, Japan; Department of Gastrointestinal and Medical Oncology, NHO Kyushu Cancer Center, Fukuoka, Japan; UNC Lineberger Comprehensive Cancer Center, 170 Manning Drive, CB# 7305 Chapel Hill, NC, 27599, USA. Electronic address: nishijima.tomohiro.zg@mail.hosp.go.jp. 2. Department of Gastrointestinal and Medical Oncology, NHO Kyushu Cancer Center, Fukuoka, Japan. Electronic address: taitoesaki@gmail.com. 3. Department of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan. Electronic address: masarum@surg2.med.kyushu-u.ac.jp. 4. Department of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan. Electronic address: toh.yasushi.nkcc.prs.8@gmail.com.
Abstract
BACKGROUND: We aimed to evaluate the potential utility of the Robinson Frailty Score (RFS), the Edmonton Frail Scale (EFS), and the G8 tool for predicting postoperative adverse events (AEs) in older adults with cancer. METHODS: We included consecutive older adults evaluated at geriatric oncology service before undergoing oncologic surgery between September 2018 and December 2019. The RFS measures cognition, function, falls, comorbidity, albumin, and hematocrit. The EFS evaluates cognition, function, incontinence, self-perceived health, mood, nutrition, polypharmacy, and social support. These scales classify patients into three frailty categories (fit, pre-frail, or frail). The G8 score was dichotomized at a cut-off value of 14. The primary outcome was composite AEs including 30-day postoperative complications (≥Clavien-Dindo grade II) and discharge to an institutional care facility. The severity of surgery was assessed using the Operative Stress Score (OSS). RESULTS: Among 114 patients (median age 80 years, range 72-96 years), the main surgery types were gastrointestinal (62%), and head and neck (20%). Using the OSS, surgical procedures were classified as very low to low-stress (9%), moderate-stress (31%), high-stress (46%), and very high-stress (15%). Forty-five patients (40%) experienced postoperative AEs. After adjusting for the OSS, preoperative RFS was significantly associated with AEs (fit: 25%, pre-frail: 49%, frail: 77%; p < 0.01). However, the EFS (fit: 30%, pre-frail: 37%, frail: 60%; p = 0.14) and the G8 tool (score >14: 17%, score ≤14: 41%; p = 0.07) were not significantly associated with the risk of AEs. CONCLUSION: The RFS is predictive of postoperative AEs in older adults undergoing elective surgery for cancer.
BACKGROUND: We aimed to evaluate the potential utility of the Robinson Frailty Score (RFS), the Edmonton Frail Scale (EFS), and the G8 tool for predicting postoperative adverse events (AEs) in older adults with cancer. METHODS: We included consecutive older adults evaluated at geriatric oncology service before undergoing oncologic surgery between September 2018 and December 2019. The RFS measures cognition, function, falls, comorbidity, albumin, and hematocrit. The EFS evaluates cognition, function, incontinence, self-perceived health, mood, nutrition, polypharmacy, and social support. These scales classify patients into three frailty categories (fit, pre-frail, or frail). The G8 score was dichotomized at a cut-off value of 14. The primary outcome was composite AEs including 30-day postoperative complications (≥Clavien-Dindo grade II) and discharge to an institutional care facility. The severity of surgery was assessed using the Operative Stress Score (OSS). RESULTS: Among 114 patients (median age 80 years, range 72-96 years), the main surgery types were gastrointestinal (62%), and head and neck (20%). Using the OSS, surgical procedures were classified as very low to low-stress (9%), moderate-stress (31%), high-stress (46%), and very high-stress (15%). Forty-five patients (40%) experienced postoperative AEs. After adjusting for the OSS, preoperative RFS was significantly associated with AEs (fit: 25%, pre-frail: 49%, frail: 77%; p < 0.01). However, the EFS (fit: 30%, pre-frail: 37%, frail: 60%; p = 0.14) and the G8 tool (score >14: 17%, score ≤14: 41%; p = 0.07) were not significantly associated with the risk of AEs. CONCLUSION: The RFS is predictive of postoperative AEs in older adults undergoing elective surgery for cancer.
Authors: Lindsay A Hampson; Anne M Suskind; Benjamin N Breyer; Lillian Lai; Matthew R Cooperberg; Rebecca L Sudore; Salomeh Keyhani; I Elaine Allen; Louise C Walter Journal: Urology Date: 2021-05-15 Impact factor: 2.633
Authors: Yoon Penning; Antoine El Asmar; Michel Moreau; Julie Raspé; Lissandra Dal Lago; Thierry Pepersack; Vincent Donckier; Gabriel Liberale Journal: PLoS One Date: 2022-03-03 Impact factor: 3.240