Mp08-06 Unraveling the Web of Frailty: A Novel Approach to Frailty Using a Cga-Derived Spider Plot

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP08)1 May 2024MP08-06 UNRAVELING THE WEB OF FRAILTY: A NOVEL APPROACH TO FRAILTY USING A CGA-DERIVED SPIDER PLOT Dana Cavanaugh, Sarah Holt, Erin Petersen, Samia Jannat, Jonathan Wright, John Gore, George Schade, and Sarah Psutka Dana CavanaughDana Cavanaugh , Sarah HoltSarah Holt , Erin PetersenErin Petersen , Samia JannatSamia Jannat , Jonathan WrightJonathan Wright , John GoreJohn Gore , George SchadeGeorge Schade , and Sarah PsutkaSarah Psutka View All Author Informationhttps://doi.org/10.1097/01.JU.0001008780.87855.57.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Frailty predicts increased complications and mortality in bladder cancer (BC). Measuring frailty is challenging because using a single frailty instrument risks oversimplifying patients' multidimensional vulnerabilities. Guidelines endorse a Comprehensive Geriatric Assessment (CGA) to quantify frailty across domains of physical function, mental health/cognition, nutrition, and multimorbidity. However, CGA's extensive data is hard to integrate into busy clinical practice. We propose a novel CGA-derived Frailty Spider Plot to synthesize identified vulnerabilities into a clinically useful frailty profile. METHODS: Urothelial cancer patients, prospectively enrolled (9/2020-7/2021) in a multidisciplinary BC clinic, completed a CGA with validated assessments of functional status, multimorbidity, nutrition, cognition, and mental health, augmented with CT-derived body composition assessments of muscle mass and adiposity. Spearman Correlation Coefficients quantified relationships between frailty domains. Spider plots were developed to visually depict distinct frailty phenotypes with CGA instruments grouped by domain as plot spokes. Nodes were determined by validated thresholds. Outer ring values indicated greater frailty. RESULTS: Of the 67 patients (median age 71, 16.4% female), 77.6% had muscle-invasive BC (20.9% cN1+, 7.6% M1). CGAs identified key vulnerabilities beyond a standard risk assessment: 31% vulnerable-to-moderately frail, 24% at risk for falls, 21% with mild-severe depression, 3% with mild-moderate dementia, 34% at risk for malnutrition, and 6% malnourished. Most frailty measures had weak correlations (rho <|0.5|). Individuals' specific risk profiles were plotted on a Spider Plot (Figure 1). CONCLUSIONS: In this prospective observational cohort, CGAs identified key vulnerability profiles. Notably, even within a domain, instruments had low correlations, highlighting the discrete data provided across multidimensional assessments. Our novel Spider plot approach visually consolidates this vast data into a single depiction of the key actionable components of frailty to inform personalized prehabilitation interventions. Future work will refine risk assessment instruments to best predict clinical outcomes, creating parsimonious Frailty Spider Plots for clinical use. Download PPT Source of Funding: BCAN Young Investigator Award © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e116 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Dana Cavanaugh More articles by this author Sarah Holt More articles by this author Erin Petersen More articles by this author Samia Jannat More articles by this author Jonathan Wright More articles by this author John Gore More articles by this author George Schade More articles by this author Sarah Psutka More articles by this author Expand All Advertisement PDF downloadLoading ...