Highlights
- •About 42% of older patients with cancer in our study used assistance to complete a web-based GA.
- •Use of assistance, and longer time to complete the eRFA, was associated with frailty scores.
- •Frail patients are more likely to benefit from completion of GA to determine appropriate treatment, and because not all patients have a caregiver, innovative solutions are needed to help frail patients complete the eRFA without assistance.
Abstract
Introduction
The aim of this study was to assess the degree to which patient frailty is associated
with both need for assistance and time required to complete the eRFA, a web-based
GA tool.
Materials and Methods
We retrospectively identified patients who underwent surgery for cancer from 2015
to 2020, had a hospital length of stay ≥1 day, and completed the eRFA before surgery.
Frailty was assessed using two methods: the MSK-FI (score 0–11) and the AGD (score
0–13). Time to complete the eRFA was automatically recorded by a web-based tool; assistance
with eRFA completion was self-reported by the patient.
Results
In total, 3456 patients were included (median age, 78 years). Overall, 58% of surveys
were completed without assistance, 30% were completed with assistance, and 12% were
completed by someone other than the patient. Younger age (median age: without assistance,
77 years; with assistance, 80 years; completed by someone else, 80 years) and lower
frailty score (median AGD: 4, 6, and 8, respectively; median MSK-FI: 2, 3, and 3,
respectively) were associated with independency (all p < 0.001). Higher frailty score
was associated with longer time to complete the eRFA (all nonlinear association p < 0.001).
Conclusion
Frail patients are more likely to benefit from completion of GA to determine appropriate
treatment. Given that not all cancer patients have a caregiver who can assist completing
a digital questionnaire, innovative solutions are needed to help frail patients complete
the eRFA without assistance.
Keywords
Abbreviations:
AGD (accumulative geriatric deficit), ASA (American Society of Anesthesiologists), CI (confidence interval), eRFA (electronic Rapid Fitness Assessment), GA (geriatric assessment), MSK-FI (Memorial Sloan Kettering Frailty Index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 08, 2022
Accepted:
November 3,
2022
Received in revised form:
October 19,
2022
Received:
April 25,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
