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A laboratory frailty index (FI Lab) tool predicted poor postoperative outcomes among older patients with cancer undergoing surgery, according to study results presented in a European Oncology Nursing Society (EONS) session at ESMO Congress 2023.
Preoperative frailty is associated with worse health outcomes, including postoperative complications and mortality.
The FI Lab instrument was developed to assess preoperative frailty using routine laboratory tests and vital signs. Data from 268 patients aged 65 years and older who underwent curative colorectal cancer (CRC) resection between 2016 and 2018 were retrospectively analyzed. Preoperative FI Lab staging was compared with outcomes at 2 years.
The FI Lab tool comprised 32 items. Low frailty was defined as a score less than 0.25, moderate frailty as 0.25 to 0.40, and high frailty as more than 0.40.
The study population comprised patients mean age 72.8 years, and according to the FI Lab, preoperative frailty was low in 61.9%, moderate in 33.6%, and high in 4.5% of patients.
Stratified by FI Lab category, the 3 groups differed significantly by fall risk (F, 8.49; P <.001), dependency (F, 5.54; P =.004), and 2-year overall survival (P <.001). The FI Lab category did not associate with 2-year disease-free survival (P =.383).
Overall, patients with moderate preoperative frailty had a 1.04-point higher risk for fall (P =.008) and patients with high preoperative frailty had 7.07-point increased dependency (P =.045) and were at 4.8-times higher risk for mortality (P =.045).
In the multivariate analysis, high FI Lab frailty, age 80 years and older, and hypertension were independent predictors for poor prognosis.
A limitation of the FI Lab instrument was the lack of cognitive or emotional components in the score.
Hyangkyu Lee, RN, PhD, of the Yonsei University Hospital in South Korea and presenter of the study concluded that the FI Lab was an easy alternative method for evaluating patients in the acute setting.
Reference
Lee H, Lim S. Impact of the medical record-based frailty index on the health outcomes of elderly patients with colorectal cancer. Presented at: ESMO Congress 2023. October 20-24, 2023. Madrid, Spain. Abstract CN18.
