Predicting frailty domain impairments and mortality with the Hospital Frailty Risk Score among older adults with cancer: the ELCAPA-EDS cohort study

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-10-14 DOI:10.1093/ageing/afae222
Charline Jean, Elena Paillaud, Pascaline Boudou-Rouquette, Claudia Martinez-Tapia, Frédéric Pamoukdjian, Meoïn Hagège, Stéphane Bréant, Claire Hassen-Khodja, Pierre-André Natella, Tristan Cudennec, Marie Laurent, Philippe Caillet, Florence Canouï-Poitrine, Etienne Audureau
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Abstract

Background Automated frailty screening tools like the Hospital Frailty Risk Score (HFRS) are primarily validated for care consumption outcomes. We assessed the predictive ability of the HFRS regarding care consumption outcomes, frailty domain impairments and mortality among older adults with cancer, using the Geriatric 8 (G8) screening tool as a clinical benchmark. Methods This retrospective, linkage-based study included patients aged ≥70 years with solid tumor, enrolled in the Elderly Cancer Patients (ELCAPA) multicentre cohort study (2016–2020) and hospitalized in acute care within the Greater Paris University Hospitals. HFRS scores, which encompass hospital-acquired problems and frailty-related syndromes, were calculated using data from the index admission and the preceding 6 months. A multidomain geriatric assessment (GA), including cognition, nutrition, mood, functional status, mobility, comorbidities, polypharmacy, incontinence, and social environment, was conducted at ELCAPA inclusion, with computation of the G8 score. Logistic and Cox regressions measured associations between the G8, HFRS, altered GA domains, length of stay exceeding 10 days, 30-day readmission, and mortality. Results Among 587 patients included (median age 82 years, metastatic cancer 47.0%), 237 (40.4%) were at increased frailty risk by the HFRS (HFRS>5) and 261 (47.5%) by the G8 (G8≤10). Both HFRS and G8 were significantly associated with cognitive and functional impairments, incontinence, comorbidities, prolonged length of stay, and 30-day mortality. The G8 was associated with polypharmacy, nutritional and mood impairment. Discussion Although showing significant associations with short-term care consumption, the HFRS could not identify polypharmacy, nutritional, mood and social environment impairments and showed low discriminatory ability across all GA domains.
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用医院虚弱风险评分预测癌症老年人的虚弱领域损伤和死亡率:ELCAPA-EDS 队列研究
背景 医院虚弱风险评分(HFRS)等自动虚弱筛查工具主要针对护理消耗结果进行验证。我们以老年医学 8(G8)筛查工具为临床基准,评估了 HFRS 对老年癌症患者的护理消耗结果、虚弱领域损伤和死亡率的预测能力。方法 这项基于链接的回顾性研究纳入了年龄≥70岁的实体瘤患者,他们都参加了老年癌症患者(ELCAPA)多中心队列研究(2016-2020年),并在大巴黎大学医院接受了急诊住院治疗。HFRS评分包括医院获得性问题和虚弱相关综合征,通过索引入院和之前6个月的数据计算得出。在纳入 ELCAPA 时进行了多领域老年评估 (GA),包括认知、营养、情绪、功能状态、活动能力、合并症、多药治疗、大小便失禁和社会环境,并计算出 G8 分数。逻辑回归和 Cox 回归测量了 G8、HFRS、GA 领域改变、住院时间超过 10 天、30 天再入院和死亡率之间的关系。结果 在纳入的 587 名患者(中位年龄为 82 岁,转移性癌症患者占 47.0%)中,有 237 人(40.4%)的 HFRS(HFRS>5)和 261 人(47.5%)的 G8(G8≤10)存在虚弱风险增加的情况。HFRS 和 G8 均与认知和功能障碍、大小便失禁、合并症、住院时间延长和 30 天死亡率密切相关。G8 与多药、营养和情绪障碍有关。讨论 虽然 HFRS 与短期护理消耗有明显相关性,但它无法识别多重药物、营养、情绪和社会环境损害,而且在所有 GA 领域都显示出较低的判别能力。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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