Key result
A preoperative Laboratory Frailty Index score > 0.4 was associated with a more than four-fold increased risk of mortality (HR 4.29) compared to a score < 0.25 in older patients undergoing cancer resection.
Why the study?
Frailty in older patients predicts poor postoperative outcomes, creating a need to validate uncomplicated frailty measurement tools like routine laboratory-based indices in busy clinical settings.
Does a higher preoperative Laboratory Frailty Index (FI-Lab) score predict worse postoperative outcomes in older surgical patients with cancer?
Cohort (n=9,015)
No
Does a higher preoperative Laboratory Frailty Index (FI-Lab) score predict worse postoperative outcomes in older surgical patients with cancer?
Hazard Ratio: 4.29 (95% CI 3.41–5.4)
Absolute Event Rate: 30% vs 5.5%
p-value: p=<0.001
The preoperative Laboratory Frailty Index (FI-Lab) is a useful tool for predicting postoperative length of stay, readmission, ICU admission, and mortality in older patients undergoing cancer resection.
May aid preoperative risk stratification in older cancer surgery patients; leaves open prospective validation before routine adoption.
Frailty in older patients is associated with poor postoperative outcomes. The use of uncomplicated frailty measurement tools is preferred in busy clinical settings. Therefore, we validated the frailty index using routine laboratory data and the surgical outcomes of older patients with cancer who underwent cancer resection. We retrospectively analyzed 9015 patients aged 65 years and older who underwent cancer resection at a single tertiary hospital. Based on electronic-medical-record data regarding preoperative blood test results and vital signs, Laboratory Frailty Index (FI-Lab) scores were generated to measure preoperative frailty. The associations of FI-Lab with postoperative length of stay (LOS), readmission within 30 days, intensive care unit (ICU) admission within 30 days, and mortality were evaluated. The mean FI-Lab score of the 9015 patients was 0.20 ± 0.10. Increased FI-Lab scores (0.25-0.4; > 0.4) were associated with longer LOS, increased readmission within 30 days of surgery, ICU admission, and increased mortality, compared with FI-Lab scores < 0.25. The FI-Lab score, as a frailty indicator, was able to predict the risk of poor postoperative outcomes. Therefore, the FI-Lab is a potentially useful tool for assessing preoperative frailty in older patients with cancer in acute clinical setting.
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Kim et al. (2022) conducted a cohort in Cancer requiring surgical resection (n=9,015). High Laboratory Frailty Index (FI-Lab > 0.4) vs. Low Laboratory Frailty Index (FI-Lab < 0.25) was evaluated on Mortality (HR 4.29, 95% CI 3.41-5.40, p=<0.001). A preoperative Laboratory Frailty Index score > 0.4 was associated with a more than four-fold increased risk of mortality (HR 4.29) compared to a score < 0.25 in older patients undergoing cancer resection.
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