Does the Japanese National Clinical Database Risk Calculator correlate with established frailty assessment tools in older adults undergoing colorectal cancer surgery?
The NCD Risk Calculator's predicted fall risk strongly correlates with established frailty indices and may serve as a practical surrogate for frailty assessment in older patients undergoing colorectal cancer surgery.
PURPOSE: To assess whether frailty in older adults undergoing colorectal cancer surgery correlates with perioperative complication risks predicted by the Japanese National Clinical Database (NCD) Risk Calculator. METHODS: The subjects of this retrospective study were 143 patients aged ≥ 75 years, who underwent comprehensive geriatric assessment (CGA) before elective colorectal tumor resection at the NHO Kyushu Cancer Center (2018-2023). Frailty was evaluated using the 10-item CGA Frailty Index (FI-CGA-10) and the Robinson Frailty Score (RFS). Correlation and receiver operating characteristic (ROC) analyses were performed, with validation using descriptive statistics based on cutoff values derived from the ROC analysis. RESULTS: The median age of the patients was 80 years and frailty (FI-CGA-10 > 0.35 or RFS > 4) was identified in 29%. Both FI-CGA-10 (r = 0.8086) and RFS (r = 0.7362) showed strong correlations with the predicted postoperative fall risk. ROC analysis identified 52.0% and 46.1% of the patients as having optimal fall risk thresholds for detecting frailty, using FI-CGA-10 and RFS, respectively. Validation showed that patients with a predicted fall risk ≥ 52% had significantly higher rates of receiving palliative treatment, suffering postoperative complications, and not being discharged home. CONCLUSION: The NCD Risk Calculator may serve as a practical surrogate for frailty assessment in older patients undergoing colorectal cancer surgery, particularly in resource-limited settings.
Sugiyama et al. (Tue,) studied this question.