CN18 - Impact of the medical record-based frailty index on the health outcomes of elderly patients with colorectal cancer

Background

Preoperative frailty in older patients with cancer is associated with poor health outcomes, such as falls, length of hospital stay, complications and mortality. Simple and clinically detectable frailty measurements are preferred in clinical settings. A laboratory frailty index (FI-Lab) based on routine laboratory tests and vital signs was suggested to assess and predict clinical outcomes in older adults. The purpose of this study was to examine the association between preoperative frailty and postoperative risk of fall and dependence, and mortality in elderly patients with colorectal cancer.

Methods

We retrospectively analyzed 268 geriatric patients (≥65 years) who received a curative resection for colorectal cancer. A 32-item FI-Lab was constructed based on routine blood tests and vital signs, and scores were rated as low (<0.25), moderate (0.25-0.40) and high (>0.40). The skeletal muscle mass was measured with CT images. The Johns Hopkins Fall Risk Assessment Tool and Modified Barthel Index were used to assess fall risk and dependency, and survival rates were evaluated.

Results

The mean age of participants was 72.3 years, 61.9% (n = 166), 33.6% (n = 90), and 4.5% (n = 12) were in the low, moderate, and high FI-Lab groups, respectively. Frailty was associated with old age, poor tumor differentiation, increased fall risk and dependency. The two-year survival rate was very low among the moderate and high frailty groups, and the risk of fall and dependency was significantly associated with the survival rate. The multidimensional Cox proportionate risk model showed that high frailty, age 80 years and older, and hypertension were independent predictors of poor prognosis. There were no significant differences in the skeletal muscle mass and density according to frailty.

Conclusions

The FI-Lab score was used to predict the risk of poor post-operative outcomes as a frailty indicator. The FI-Lab is a potentially useful tool for hospitalized elderly patients who are at higher risk of frailty and helps healthcare professionals implement strategies to improve health outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

The National Research Foundation of Korea.

Disclosure

The author has declared no conflicts of interest.