Abstract
Background
Measuring frailty in older adults with cancer may identify patients with an increased
risk of treatment complications. As it remains controversial how to identify frailty,
the aim of this study was to compare a pre-operative multi-domain frailty measure
based on a comprehensive geriatric assessment (CGA) to a modified version of the physical
phenotype of frailty (PF) in a cohort of older adults with colorectal cancer, and
to analyze the ability of the two classifications to predict post-operative complications
and survival.
Methods
A prospective longitudinal study including 176 patients aged 70–94 years electively operated for colorectal cancer in three Norwegian hospitals. A pre-operative
CGA, self-reported quality of life, and measurements of grip strength and gait speed
were performed. CGA-frailty was defined as fulfilling one or more of the following criteria: dependency in activities of daily living, severe comorbidity,
cognitive dysfunction, depression, malnutrition, or >seven daily medications. PF was defined with three or more of the following criteria:
unintentional weight loss, exhaustion, low physical activity, impaired grip strength,
or slow gait speed. Outcome measures were post-operative complications and survival.
Results
The agreement between the classifications was poor. CGA-frailty was identified in
75 (43%) patients, while PF was identified in 22 (13%) patients. Only CGA-frailty
predicted post-operative complications [P=0.001]. Both measures predicted survival.
Conclusions
A multi-domain frailty measure based on a CGA was more useful than frailty identified
from a modified version of the PF criteria in predicting post-operative complications.
For overall survival, both frailty measures were predictive.
Keywords
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Article info
Publication history
Published online: November 14, 2011
Accepted:
September 30,
2011
Received in revised form:
September 20,
2011
Received:
June 21,
2011
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
