ArticleJournal of the American Geriatrics Society2025
Frailty screening in older patients undergoing elective colorectal surgery: Comparative study of seven screening instruments.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Navigating long-term patient-reported outcomes after colorectal cancer surgery in older adults: ostomy, nutritional status, and living conditions as determinants in a prospective cohort study.International journal of colorectal disease · 2026Observational
- Decoding the association between CT-derived body composition metrics and prognosis in stage II rectal cancer.Insights into imaging · 2026Article
- Decoding the Effect of Frailty vs. Physiologic Age in Octogenarian and Nonagenarian Colectomy Outcomes for Colon Cancer.Journal of clinical medicine · 2025Article
- Clinical Frailty Scale predicts overall survival after colon cancer surgery in people aged 80 years and older: A prospective multicentre observational study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Observational
- Frailty screening in older patients undergoing elective colorectal surgery: Comparative study of seven screening instruments.Journal of the American Geriatrics Society · 2025Article
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Authors and funding
7 authors.
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Abstract
backgroundFrailty screening instruments are increasingly studied as risk predictors for adverse postoperative outcomes. However, because of the lack of comparative research, it is unclear which screening instrument performs best. This study therefore compared the diagnostic accuracy of seven frailty screening instruments for adverse postoperative outcomes in patients aged ≥70 years undergoing colorectal surgery.
methodsWe conducted a prospective cohort study at an academic hospital, examining the Fried and Robinson frailty criteria, the Edmonton Frail Scale, the Rockwood Clinical Frailty Scale, the Modified Frailty Index, the FRAIL questionnaire, and the Geriatric 8 for predicting postoperative complications with a Clavien-Dindo (CD) severity grade ≥2. Secondary outcomes were complications with CD severity grade ≥3, prolonged length of stay, increased care level after discharge, and functional decline in basic or instrumental activities of daily living up to 1 month after surgery.
resultsThe study included 172 consecutive patients. Positive frailty screening ranged from 13.4% to 73.8%. CD≥2 complications were present in 37.8% of patients. At the original cutoffs, most instruments had a high specificity (76.7%-92.4%) at the expense of sensitivity (21.5%-38.5%) with a moderate negative predictive value (NPV) for predicting CD≥2 complications. The Geriatric 8 showed the opposite pattern (sensitivity 81.5%-specificity 30.8%) and a high NPV. Diagnostic accuracy was moderate for all screening instruments, since the areas under the receiver operating characteristic curve did not exceed 0.61 across instruments. Altering the cutoff scores did not yield sufficient improvement. Comparable results were found for the secondary outcomes.
conclusionsComparing the predictive value of the screening instruments showed that frailty screening cannot be used in isolation as risk predictor for adverse postoperative outcomes. Further research should focus on a two-step approach in which additional diagnosis of frailty by means of comprehensive geriatric assessment is included in the prediction model.
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