A modified frailty index predicts adverse outcomes among patients with colon cancer undergoing surgical intervention

Viraj Pandit, Muhammad Khan, Carolina Martinez, Faisal Jehan, Muhammad Zeeshan, Jenna Koblinski, Mohammad Hamidi, Pamela Omesieta, Obiyo Osuchukwu, Valentine N Nfonsam

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4 Scopus citations

Abstract

INTRODUCTION: Assessing outcomes in patients with colon cancer (CC) undergoing surgical intervention is challenging. Frailty has been as established tool for assessing patient outcomes. The aim was of this study was to assess role of frailty in patients with CC. METHODS: National estimates for patients with CC were abstracted from the National Inpatient Sample (NIS) database (2011). Frailty was calculated using a 11 variable CCFI. Patient was stratified as frail (FL) (mFI≥0.25) and non-frail (Non-FL). Outcome measures were: in-hospital complications, hospital and intensive care unit (ICU) length of stay (LOS), discharge disposition, and mortality. Regression analysis was performed. RESULTS: A total of 53,652 patients with CC who underwent surgery were analyzed. The mean age was 69 ± 19 years with 62% males and mean CCFI being 0.13. 34% of patients were frail. 22.3% patients had in-hospital complications and mortality rate was 3.2%. Frail patients were more likely to have in-hospital complications (p = 0.001), longer hospital LOS (p = 0.001), more likely to be discharged to a facility (p = 0.001). On regression analysis after controlling for age, gender, type of procedure, hospital status, insurance status, frail status was independently associated with in-hospital complications (OR[95% CI]: 1.8[1.1-2.9], p = 0.035) and adverse discharge disposition (OR[95% CI]: 1.3[1.08-3.5], p = 0.043). CONCLUSION: Frailty status is an independent predictor of adverse outcomes (complications, discharge disposition, and LOS) in CC patient undergoing surgical intervention. Age was not independently associated with outcome and had poor correlation with frailty status. Pre-operative assessment of frailty in CC patient may help early identifications and risk stratification to help improve outcomes and discharge planning.

Original languageEnglish (US)
Pages (from-to)1090-1094
Number of pages5
JournalAmerican Journal of Surgery
Volume216
Issue number6
DOIs
Publication statusPublished - Dec 1 2018
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

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