The utility of electronic frailty index in cancer patients undergoing chemotherapy

Abstract Background Frail patients with cancer (Ca) have worse survival. Current methods of assessment of fitness (performance status) for cancer treatment, such as chemotherapy, are time -consuming and often not used by practicing oncologists. The electronic frailty index (SCARF) is derived from a cumulative deficit frailty model and provides a measure of frailty alongside pre-existing conditions. We used this methodology to investigate whether it can predict outcomes of chemotherapy in patients with Ca. Methods The study conducted data analysis of Ca patients treated with chemotherapy in England, years 2015–2018; stage II–III breast Ca, stage III colon Ca and stage IIIB–IV non-small-cell lung Ca. The data was linked with hospital admissions to calculate 30-day chemotherapy mortality, overall survival and SCARF. Results The SCARF was calculated for 78,799 patients. The risk of dying within 30 days of chemotherapy in severely frail patients with colorectal cancer ≥70 y.o. was twice that of the <70 y.o. (OR 2.04 −95% CI 1.58–2.64, mild frailty 1.07–95% CI 0.78–1.45); and 6 times higher in breast cancer (OR 5.73–95% CI 2.66–12.32, mild frailty OR 1.45 95% CI 0.78–2.71). Conclusion The SCARF index predicts poor outcomes from SACT, particularly in breast and colon cancer, and it requires further evaluation.