Modified frailty index predicts postoperative outcomes in older gastrointestinal cancer patients

Background and Objectives Frailty disproportionately impacts older patients with gastrointestinal cancer, rendering them at increased risk for poor outcomes. A frailty index may aid in preoperative risk stratification. We hypothesized that high modified frailty index (mFI) scores are associated with...

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Bibliographic Details
Published in:Journal of surgical oncology 2017-06, Vol.115 (8), p.997-1003
Main Authors: Vermillion, Sarah A., Hsu, Fang‐Chi, Dorrell, Robert D., Shen, Perry, Clark, Clancy J.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cancer
Cancer surgery
Female
Frail Elderly
Frailty
gastrointestinal cancer
Gastrointestinal Neoplasms - mortality
Gastrointestinal Neoplasms - pathology
Gastrointestinal Neoplasms - surgery
Geriatric Assessment
Health Status
Humans
Incidence
Length of Stay
Male
modified frailty index
Mortality
NSQIP
Postoperative Complications - epidemiology
Postoperative period
preoperative risk stratification
Retrospective Studies
Risk Assessment
Survival Rate
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Summary:Background and Objectives Frailty disproportionately impacts older patients with gastrointestinal cancer, rendering them at increased risk for poor outcomes. A frailty index may aid in preoperative risk stratification. We hypothesized that high modified frailty index (mFI) scores are associated with adverse outcomes after tumor resection in older, gastrointestinal cancer patients. Methods Patients (60‐90 years old) who underwent gastrointestinal tumor resection were identified in the 2005‐2012 NSQIP Participant Use File. mFI was defined by 11 previously described, preoperative variables. Frailty was defined by an mFI score >0.27. The postoperative course was evaluated using univariate and multivariate analysis. Results 41 455 patients (mean age 72.4 years, 47.4% female) were identified. The most prevalent form of cancer was colorectal (69.3%, n = 28 708) and 2.8% of patients were frail (n = 1,164). Frail patients were significantly more likely to have increased length of stay (11.7 vs 9.0 days), major complications (29.1% vs 17.9%), and 30‐day mortality (5.6% vs 2.5%), (all P 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.24617