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Oncogeriatrics (part 8.). Frailty screening tools
Affiliations- Department of General, Oncologic and Geriatric Surgery, III Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland
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Abstract
Various frailty screening tools have been developed. However, there is currently no single ideal model; some scores are better for population-level, whereas others are best suited for clinical screening and preoperative assessment. Therefore, the choice of the score might relay on specific clinical condition, the aim of the tool and department resources. The G8 and the aCGA seem to be the the most suitable in the case of preoperative frailty assessments of older patients with solid abdominal cancer who are undergoing high-risk surgery. They also may be used to identify patients at risk for adverse postoperative outcomes. They may support the decision process particularly in situations of lack of experience in full Geriatric Assessment (easy to master and implement), in acute admitted patients (time pressure or some of the domains cannot be assessed) and in case of low-/moderate-risk surgery (where extensive frailty evaluation may not influence the postoperative outcome).
Abstract
Various frailty screening tools have been developed. However, there is currently no single ideal model; some scores are better for population-level, whereas others are best suited for clinical screening and preoperative assessment. Therefore, the choice of the score might relay on specific clinical condition, the aim of the tool and department resources. The G8 and the aCGA seem to be the the most suitable in the case of preoperative frailty assessments of older patients with solid abdominal cancer who are undergoing high-risk surgery. They also may be used to identify patients at risk for adverse postoperative outcomes. They may support the decision process particularly in situations of lack of experience in full Geriatric Assessment (easy to master and implement), in acute admitted patients (time pressure or some of the domains cannot be assessed) and in case of low-/moderate-risk surgery (where extensive frailty evaluation may not influence the postoperative outcome).
Keywords
older cancer patients; frailty screening; G8; aCGA; VES-13; TRST; Fried; GFI; Rockwood; Balducci
About this articleTitle
Oncogeriatrics (part 8.). Frailty screening tools
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
184-186
Published online
2020-09-10
Page views
489
Article views/downloads
555
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2020;70(5):184-186.
Keywords
older cancer patients
frailty screening
G8
aCGA
VES-13
TRST
Fried
GFI
Rockwood
Balducci
Authors
Jakub Kenig
References (18)- Kenig J, Szabat K. Oncogeriatric (part 7). Geriatric Assessment for older patients with cancer. NOWOTWORY J Oncol. 2020; 70: 85–91.
- Bolle S, Smets EMA, Hamaker ME, et al. Medical decision making for older patients during multidisciplinary oncology team meetings. J Geriatr Oncol. 2019; 10(1): 74–83.
- Eamer G, Taheri A, Chen SS, et al. Comprehensive geriatric assessment for older people admitted to a surgical service. Cochrane Database Syst Rev. 2018; 1: CD012485.
- Saliba S, Elliott M, Rubenstein LA, et al. The Vulnerable Elders Survey (VES-13): A Tool for Identifying Vulnerable Elders in the Community. JAGS. 2001; 49: 1691–1699.
- Meldon SW, Mion LC, Palmer RM, et al. A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department. Acad Emerg Med. 2003; 10(3): 224–232.
- Soubeyran P, Bellera CA, Gregoire F, et al. Validation of a screening tool in geriatric oncology: the Oncodage project. J Clin Oncol. 2008; 26: abstr.
- Slaets JPJ. Vulnerability in the elderly: frailty. Med Clin North Am. 2006; 90(4): 593–601.
- Overcash JA, Beckstead J, Moody L, et al. The abbreviated comprehensive geriatric assessment (aCGA) for use in the older cancer patient as a prescreen: scoring and interpretation. Crit Rev Oncol Hematol. 2006; 59(3): 205–210.
- Rockwood K, Stadnyk K, MacKnight C, et al. A brief clinical instrument to classify frailty in elderly people. Lancet. 1999; 353(9148): 205–206.
- Balducci L, Beghe C. The application of the principles of geriatrics to the management of the older person with cancer. Crit Rev Oncol Hematol. 2000; 35(3): 147–154.
- Fried LP, Tangen CM, Walston J, et al. Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3): M146–M156.
- Decoster L, Van Puyvelde K, Mohile S, et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations†. Ann Oncol. 2015; 26(2): 288–300.
- Kenig J, Szabat K, Mituś J, et al. Usefulness of eight screening tools for predicting frailty and postoperative short- and long-term outcomes among older patients with cancer who qualify for abdominal surgery. Eur J Surg Oncol. 2020 [Epub ahead of print].
- Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med. 2016; 31: 3–10.
- Biganzoli L, Mislang AR, Di Donato S, et al. Screening for Frailty in Older Patients With Early-Stage Solid Tumors: A Prospective Longitudinal Evaluation of Three Different Geriatric Tools. J Gerontol A Biol Sci Med Sci. 2017; 72(7): 922–928.
- Bongue B, Buisson A, Dupre C, et al. Predictive performance of four frailty screening tools in community-dwelling elderly. BMC Geriatr. 2017; 17(1): 262.
- Hall DE, Arya S, Schmid KK, et al. Association of a Frailty Screening Initiative With Postoperative Survival at 30, 180, and 365 Days. JAMA Surg. 2017; 152(3): 233–240.
- Huisman MG, Audisio RA, Ugolini G, et al. Screening for predictors of adverse outcome in onco-geriatric surgical patients: A multicenter prospective cohort study. Eur J Surg Oncol. 2015; 41(7): 844–851.