Researchers demonstrated that frailty may be a factor in some outcomes following surgery in patients with ovarian cancer, according to study findings recently reported in the journal Gynecological Oncology.

Patients evaluated in this study underwent laparotomy for ovarian cancer during the years 2010 through 2014 and were identified through the Nationwide Readmissions Database. They were considered frail or not frail using the Johns Hopkins Adjusted Clinical Groups Frailty Diagnoses indicators. Outcomes were evaluated for patients at index admission and at 30 and 90 days following surgery.

In this study, a total of 76,441 inpatient laparotomies were found. The frailty rate among the involved patients was 6.1%. Frailty was associated with risks of multiple poorer outcomes during the index admission. These included a higher risk of inpatient mortality (adjusted risk ratio [aRR], 1.91; 95% CI, 1.63-2.23; P <.01). Also, during index admission, frailty was linked to a higher risk of a requirement for intensive care (aRR, 1.76; 95% CI, 1.68-1.85; P <.01) and to a higher risk of nonroutine discharge (aRR, 1.39; 95% CI, 1.33-1.45; P <.01).


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In the 90 days following surgery, frailty was associated with readmission (aRR, 1.11; 95% CI, 1.04-1.18; P <.01) and with mortality during a readmission (aRR, 1.31; 95% CI, 1.01-1.69; P =.04). The 30-day aRR for readmission with frailty was 1.09 (95% CI, 1.01-1.17; P =.02), and frailty was not associated with mortality during readmission in the 30-day period (aRR, 1.20; 95% CI, 0.88-1.63; P =.25).

The researchers concluded that in this study of patients with ovarian cancer, frailty was linked to some worse outcomes following surgery. “Because management of ovarian cancer generally involves surgery, our results suggest that all ovarian cancer patients, particularly ages 50 and older, should be screened for frailty at their preoperative visit,” the study investigators wrote in their report.

Disclosures: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Sia TY, Wen T, Cham S, Friedman AM, Wright JD. Effect of frailty on postoperative readmissions and cost of care for ovarian cancer. Gynecol Oncol. Published online August 28, 2020. doi:10.1016/j.ygyno.2020.08.024