Observational studyPloS one2023
Edmonton Frail Scale predicts mortality in older patients with cancer undergoing radiotherapy-A prospective observational study.
Observational study in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications.Cardiovascular diabetology · 2025Pooled it
- Unraveling the impact of frailty on postoperative delirium in elderly surgical patients: a systematic review and meta-analysis.BMC anesthesiology · 2025Pooled it
- Translation, Cross-Cultural Adaptation and Validation of the Serbian Version of the Clinical Frailty Scale in Patients Undergoing Major Uro-Oncological Surgery.Healthcare (Basel, Switzerland) · 2026Article
- Tumor burden and frailty: No association in liver transplantation candidates with hepatocellular carcinoma.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- The Edmonton frail scale: a feasibility study on assessing frailty among older adults with multimorbidity in Norwegian primary health care.BMC primary care · 2025Article
- Prevalence and incidence of falls in older adults with cancer: a systematic review with meta-analysis.Journal of cancer survivorship : research and practice · 2025Review
- Exceeding the Limits with Nutraceuticals: Looking Towards Parkinson's Disease and Frailty.International journal of molecular sciences · 2024Review
- Article
- The Edmonton Frail Scale as a screening score for frailty in oncogeriatrics.Frontiers in medicine · 2024Article
- Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral screening tools are developed to identify frailty in the increasing number of older patients with cancer. Edmonton Frail Scale (EFS) performs well in geriatric settings but is less studied in oncology. We aimed to investigate if EFS score (continuous and categorical) predicts survival in patients referred for radiotherapy, and to assess the concurrent validity of EFS compared with a modified geriatric assessment (mGA).
methodsProspective observational, single-center study including patients ≥65 years, referred for curative or palliative radiotherapy for confirmed cancer. Patients underwent mGA (assessment of cognition, mobility, falls, comorbidity, polypharmacy, depression, nutrition, and activities of daily living) and screening with EFS prior to radiotherapy. The predictive value of EFS score of two-year overall survival (OS) was assessed by Kaplan-Meier plots and compared by log-rank test. Cox proportional hazards regression model was estimated to adjust the associations for major cancer-related factors. Concurrent validity of EFS in relation to mGA was estimated by Spearman`s correlation coefficient and ordinal regression. Sensitivity and specificity for different cut-offs was assessed.
resultsPatients' (n = 301) mean age was 73.6 (SD 6.3) years, 159 (52.8%) were men, 54% received curative-intent treatment, breast cancer (32%) was the most prevalent diagnosis. According to EFS≥6, 101 (33.7%) were classified as frail. EFS score was predictive of OS [hazard ratio (HR) 1.20 (95% confidence interval (CI) 1.10-1.30)], as was increasing severity assessed by categorical EFS (p<0.001). There was a strong correlation between EFS score and number of geriatric impairments (Spearman`s correlation coefficient 0.77). EFS cut-off ≥6 had a sensitivity of 0.97 and specificity of 0.57 for identifying patients with minimum two geriatric impairments.
conclusionEFS predicts mortality in older patients with cancer receiving radiotherapy, and it is a quick (<5 minutes) and sensitive screening tool to identify patients who may benefit from a geriatric assessment.
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