Evidence map›Paper›PMID 34350715›Full record

ArticleCancer medicine2021

A simple test-based frailty index to predict survival among cancer patients with an unplanned hospitalization: An observational cohort study.

Timothy Hembree, Olga Theou, Sarah Thirlwell, Richard R Reich, Biwei Cao, Marina Sehovic, Misbahuddin Syed, Neha Verma, Thu-Cuc Nguyen, Dinesh Keerty and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Timothy HembreeDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.ORCID 0000-0002-7276-0952
Olga TheouSchool of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.
Sarah ThirlwellDepartment of Supportive Care Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Richard R ReichBiostatistics Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Biwei CaoBiostatistics Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Marina SehovicSenior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Misbahuddin SyedDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Neha VermaDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Thu-Cuc NguyenDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Dinesh KeertyDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Jaqueline WesolowDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Viktoriya KoverzhenkoDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Martine ExtermannSenior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Jessica HuangUniversity of South Florida Morsani College of Medicine, Tampa, FL, USA.
Asha RamsakalDepartment of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.

Funding

TRANSLATIONAL RESEARCHP30CA076292 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI KENNETH Lynn WRIGHT · 1998 to 2026
$93.5M
NCI NIH HHS P30 CA076292
6 · The paper itself

Abstract

backgroundFrailty is a state of increased vulnerability to stressors, and predicts risk of adverse outcomes, such as mortality. Frailty can be defined by a frailty index (FI) using an accumulation of deficits approach. An FI comprised of 20 items derived from our previously studied test-based frailty index (TBFI) and an additional 33 survey-based elements sourced from the standard CGA was developed to evaluate if predictive validity of survival was improved.

methodsOne hundred eighty-nine cancer patients during acute hospitalization were consented between September 2018 and May 2019. Frailty scores were calculated, and patients were categorized into four groups: non-frail (0-0.2), mildly frail (0.2-0.3), moderately frail (0.3-0.4), and severely frail (>0.4). Patients were followed for 1-year to assess FI and TBFI prediction of survival. Area under the curve (AUC) statistics from ROC analyses were compared for the FI versus TBFI.

resultsIncreasing frailty was similarly associated with increased risk of mortality (HR, 4.5 [95% CI, 2.519-8.075] and HR, 4.1 [95%CI, 1.692-9.942]) and the likelihood of death at 6 months was about 11-fold (odds ratio, 10.9 [95% CI, 3.97-33.24]) and 9.73-fold (95% CI, 2.85-38.50) higher for severely frail patients compared to non-frail patients for FI and TBFI, respectively. This association was independent of age and type of cancer. The FI and TBFI were predictive of survival for older and younger cancer patients with no significant differences between models in discriminating survival (FI AUC, 0.747 [95% CI, 0.6772-0.8157] and TBFI AUC, 0.724 [95% CI, 0.6513-0.7957]).

conclusionsThe TBFI was predictive of survival, and the addition of an in-person assessment (FI) did not greatly improve predictive validity. Increasing frailty, as measured by a TBFI, resulted in a meaningfully increased risk of mortality and may be well-suited for screening of hospitalized cancer patients.

Indexed as

AdultAgedAged, 80 and overCohort StudiesFemaleFrailtyHospitalizationHumansMaleMiddle AgedNeoplasmsSurvival Analysisfrailtyhospitalizationhospital mortalityinpatientspatient readmission

Identifiers

PMID34350715
PMCPMC8419777

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.