Frailty status but not age predicts complications in elderly cancer patients: a follow-up study

Figures & data

Figure 1. Study recruitment and follow-up.

Table 1. Baseline characteristics of patients receiving CGA in the total population and in relation to the CGA classification ‘fit’, ‘vulnerable’, and ‘frail’.

	Total N = 217	Fit n = 28 (13%)	Vulnerable n = 76 (35%)	Frail n = 113 (52%)
Age, years
Median (IQR)	75 (72–80)	73 (72–76)	76 (73–80)	75 (73–80)
Range	70–93	70–87	70–90	70–93
Gender
Male, n (%)	115 (53)	12 (43)	42 (55)	61 (54)
Cancer type, n (%)
Head and Neck	14 (6)	4 (14)	4 (5)	6 (5)
Lung	93 (43)	6 (22)	28 (37)	59 (52)
UPGI	33 (15)	2 (7)	14 (18)	17 (15)
CRC	77 (36)	16 (57)	30 (40)	31 (28)*
Dissemination of cancer, n (%)
Metastatic disease**	89 (41)	4 (14)	32 (42)	53 (47)*
CGA domains
Cumulated CIRS-G-score, mean (SD)	9 (±4.2)	4 (3;4)	7 (6;7)	11(11;12)*
No. of affected organ systems, mean (SD)	5 (±2.0)	3 (2;4)	4 (2–5)	6 (5;6)*
No. of daily medications, median (IQR)	5 (3–8)	2 (2–3)	4 (3;4)	7 (5–9)*
Independent in ADL, n (%),	198 (91)	28 (100)	76 (100)	94 (85)*
Independent in IADL, n (%)	151 (70)	28 (100)	63 (83)	60 (54)*
Normal GDS-15, n (%)	159 (73)	28 (100)	74 (97)	57 (53)*
Cognitively intact, n (%)	192 (88)	28 (100)	72 (95)	92 (85)*
Well nourished, n (%)	108 (50)	28 (100)	42 (63)	32 (15)*
Social situation, n (%)
Living alone	72 (33)	8 (29)	23 (30)	41 (36)
Living conditions, n (%)
Independent housing	209 (97)	28 (100)	75 (99)	106 (94)
Sheltered housing	5 (2)	0	1 (1)	4 (4)
Nursing home	3 (1)	0	0	3 (3)
Home care services, n (%)
Daily use	48 (18)	0	4 (5)	34 (30)*
Daily use of walking aid, n (%)	48 (22)	1 (4)	6 (8)	41 (37)*
Timed Up and Go (sec), median (IQR)	11 (9–13)	9 (8–11)	10 (9–11)	12 (10–16)*
Experience daily pain, n (%)	63 (29)	3 (11)	12 (16)	48 (43)*

CIRS-G: Cumulative Illness Rating Scale-Geriatrics, ADL: Activities of Daily Living, IADL: Instrumental Activities of Daily Living, GDS: Geriatric Depression Scale.

* Statistical significance,

** 10 observations are missing.

Table 2. Initially planned cancer treatment and interventions provided following CGA in the total population and in relation to the CGA classification ‘fit’, ‘vulnerable’, and ‘frail’.

	Total	Fit	Vulnerable	Frail	p value
	N = 217	n = 28	n = 76	n = 113
Initially planned treatment, n (%)
Curatively intended	31 (14)	8 (29)	7 (9)	16 (14)
Palliatively intended	114 (53)	5 (18)	41 (54)	68 (60)
Adjuvant	41 (19)	14 (50)	21 (28)	6 (5)
No treatment planned	30 (14)	1 (4)	6 (8)	23 (20)
Missing	1	0	1 (1)	0	<0.001
Initial planned treatment modality*, n (%)
Radiotherapy	82 (44)	10 (37)	20 (29)	52 (58)	0.001
Chemo therapy	123 (66)	19 (79)	56 (80)	48 (53)	0.002
Standard dose initially planned*	141 (76)	24 (92)	43 (62)	74 (83)	0.001
Geriatric intervention provided, n (%)	159 (73)	9 (32)	51 (67)	99 (88)	<0.001
Medical intervention	137 (63)	9 (32)	39 (51)	89 (79)	0.080
Social intervention	34 (16)	1 (4)	7 (9)	26 (23)	0.120
Physical intervention	37 (17)	1 (4)	9 (12)	27 (24)	0.215
Nutritional intervention	106 (49)	4 (14)	30 (39)	72 (64)	0.025

* In the 186 patients allocated to specific cancer treatment.

Table 3. Comparison of complications in relation to initial CGA according to fit, vulnerable, and frail cancer patients.

	Dose reductiona			Discontinuation^a			Hospital admission
CGA groups	n (%)	Crude RR (95% CI)	Adjusted RR^b(95% CI)	n (%)	Crude RR(95% CI)	Adjusted RR^c(95% CI)	n (%)	Crude RR(95% CI)	Adjusted RR^b(95% CI)
Fit (n = 28)	6 (21)	1.00 (ref)	1.00 (ref)	3 (11)	1.00 (ref)	1.00 (ref)	7 (25)	1.00 (ref)	1.00 (ref)
Vulnerable (n = 76)	19 (25)	1.05	1.16	6 (9)	0.77	0.72	35 (46)	1.84	2.12^d
		(0.50; 2.20)	(0.57; 2.41)		(0.21; 2.87)	(0.19; 2.75)		(0.93;3.66)	(1.01; 4.46)
Frail (n = 113)	22 (20)	0.94	0.99	9 (10)	0.90	0.81		1.98^d	2.01
		(0.45; 1.96)	(0.47; 2.49)		(0.26; 3.09)	(0.22; 2.93)	56 (50)	(1.02; 3.87)	(0.96; 4.19)

^a Analyzed in 187 patients allocated to specific cancer treatment.

^b Adjusted for gender, age, metastatic disease, and tumor site.

^c Adjusted for tumor site.

^d Statistical significance.