Use of the Rockwood Clinical Frailty Score (CFS) in patients with advanced hepatopancreaticobiliary (HPB) malignancies

Abstract Introduction Frail patients have increased mortality after surgery. However, it is not known if pre-operative process measures such as antibiotic administration, time to CT and time to surgery are influenced by patient frailty. Method The Emergency Laparotomy and Laparoscopy Scottish Audit (ELLSA) assessed outcome after emergency surgery across Scottish hospitals (November 2017 – October 2018). Frailty was measured using the 7-point Clinical Frailty Score (CFS). Outcome measures were antibiotic provision for sepsis, admission to CT time, admission to surgery time, CT request to performance time and CT request to surgery time. Results 1302 patients (median age 63 years [IQR 49-74]; 49% male) with complete data were included. Median time from admission to CT and surgery increased between those with CFS 1 to 6/7 from 597 to 1724 minutes (p < 0.0001) and 1556 to 4120 minutes (p < 0.0001) respectively. Time from CT request to surgery also significantly increased with CFS (p < 0.042). There was no significant association between CFS and antibiotic administration or CT request to performance. Conclusions Frail patients have to wait longer for CT scan requests and surgery, but frailty was not associated with antibiotic administration or delays in CT request to performance time. Possible explanations include frailty-related challenges making correct diagnoses and optimal management plans.

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Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients

Journal of Pharmaceutical Health Care and Sciences ◽

10.1186/s40780-021-00195-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yuya Uragami ◽

Kazuhiro Takikawa ◽

Hajime Kareki ◽

Koji Kimura ◽

Kazuyuki Yamamoto ◽

...

Keyword(s):

Early Stage ◽

Linear Trend ◽

Cross Sectional Study ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Antithrombotic Drugs ◽

Cross Sectional ◽

The Relationship ◽

Inappropriate Medications ◽

Frailty Score

Abstract Background Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan. Methods A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score. Results Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p < 0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score. Conclusions Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings.

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160 The Effect of Frailty and COVID-19 Infection on Clinical Outcomes in Older Adults—A Single Centre Retrospective Study

Age and Ageing ◽

10.1093/ageing/afab030.121 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

O Okuwoga ◽

S Mufti

Keyword(s):

Older Patients ◽

Single Centre ◽

Clinical Frailty Scale ◽

Health Records ◽

Frail Patients ◽

Nice Guidance ◽

Data Points ◽

Continued Use ◽

Support Decision Making ◽

Frailty Score

Abstract Introduction It was anticipated that the COVID-19 pandemic would put a strain on our healthcare system, disproportionately affecting older people. NICE guidance recommended using frailty scoring to support decision making around escalation of care. This study aimed to assess frailty, demographics and COVID-19 infection and to investigate how these related to outcomes of patients aged over 65 years admitted to hospital. Methods A single centre retrospective cohort study was carried out by reviewing the electronic health records of all admissions over 65 years. Data points collected included length of stay (LOS), frailty score using the Rockwood Clinical Frailty Scale (CFS) and mortality. Patients were stratified into COVID and non-COVID based on health records and into non-frail (CFS 1–4) and frail (CFS 5–9). Results A total of 257 patients admitted between 30th March and 30th April 2020 were included in the study (mean age 79 years, 43% female). 141 (54.9%) of patients were diagnosed with COVID-19 infection. 120 patients had CFS 1–4 and 136 has CFS 5–9. 1 patient did not have a frailty score due to insufficient information. 68 (26.8%) of all patients died during the admission. The relative risk (RR) of mortality of patients with coronavirus was 6.3 (95% CI 3.1–12.6, p < 0.0001). The RR of mortality for frail patients compared to the non-frail was 2.1 (95% CI 1.3–3.2, p = 0.002). The median LOS for patients with COVID-19 was 5 days, compared to 4 days for patients who did not have coronavirus. Frailty did not predict longer admission, with median LOS of 5 days for both non-frail and frail patients. Conclusion The results demonstrated in this study show that COVID-19 infection and frailty were significantly associated with increased mortality in older patients. This validates the continued use of frailty scoring of older patients on admission to support care planning.

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Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report

Blood ◽

10.1182/blood-2014-12-615187 ◽

2015 ◽

Vol 125 (13) ◽

pp. 2068-2074 ◽

Cited By ~ 319

Author(s):

Antonio Palumbo ◽

Sara Bringhen ◽

Maria-Victoria Mateos ◽

Alessandra Larocca ◽

Thierry Facon ◽

...

Keyword(s):

Elderly Patients ◽

Geriatric Assessment ◽

Working Group ◽

Key Points ◽

Group Report ◽

Assessment Strategies ◽

International Myeloma Working Group ◽

Frailty Score

Key Points Elderly patients with myeloma are heterogeneous and assessment strategies are needed to define the frailty profile. The proposed frailty score aims to better assess patients and provide them with more suitable therapies.

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Abdominal hysterectomy and high frailty score are associated with complications among older patients

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.14029 ◽

2021 ◽

Author(s):

Julia J. Wainger ◽

Golsa Yazdy ◽

Victoria L. Handa

Keyword(s):

Older Patients ◽

Abdominal Hysterectomy ◽

Frailty Score

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FRAILTY IS NOT ASSOCIATED WITH MISTREATMENT

Journal of Frailty & Aging ◽

10.14283/jfa.2017.29 ◽

2017 ◽

pp. 1-4

Author(s):

S.D. Piña-Escudero ◽

J.M.A. García-Lara ◽

J.A. Avila-Funes

Keyword(s):

Cross Sectional Study ◽

Social Consequences ◽

Community Dwelling ◽

Frailty Phenotype ◽

Cross Sectional ◽

Logistic Regression Models ◽

Health Related ◽

The Mean ◽

Unadjusted Analysis ◽

Frailty Score

Muscle Frailty has been previously associated with increased vulnerability for adverse health-related outcomes that could lead to social consequences such as mistreatment. The aim of this cross-sectional study is to determine the association between frailty and mistreatment in 852 community-dwelling persons aged 70 or older. Mistreatment was defined as one positive answer in the Geriatric Mistreatment Scale and frailty was used as a continuum where the greater number of positive criteria according to Fried et al. indicates a higher frailty score. Multivariate logistic regression models were run to establish this association. The mean age of participants was 77.7 years (SD=6.1). Prevalence of frailty phenotype and mistreatment were 13.9% and 20% respectively. Unadjusted analysis showed frailty score was associated with mistreatment (OR = 1.16; 95% CI 1.02 to 1.3, p=0.022). However, after adjustment, the association was no longer present. The results showed that in the presence of other geriatric syndromes such as disability or depression, frailty did not show association with mistreatment in this population.

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