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The association between perioperative frailty and ability to complete a web-based geriatric assessment among older adults with cancer

Published:November 08, 2022DOI:https://doi.org/10.1016/j.ejso.2022.11.011

      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)
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