New weakness index developed by clinicians from the Cancer Center Memorial Sloan Kettering, New York, has become easier to use for evaluation of elderly patients with cancer undergoing surgery.
"Older cancer patients at increased risk of morbidity and mortality after surgery. However, among elderly patients there is a difference in terms of weaknesses, "- says the study's first author, Armin Shahrokni, MD. He and his colleagues described the index of weakness MSK-Frailty Index (MSK-FI) in an article published in JAMA Network Open.
«MSK-FI is very easy to use" - says Shahrokni. The surgeon should ask five basic questions related to daily activities. He explained that the information on the remaining variables needed to calculate the points MSK-FI, extracted from the code ICD9 / 10 provided by the institution during the first 48 hours after admission.
The researchers assessed the MSK-FI in 1137 cancer patients (mean age - 80 years; 51% women). Average on a scale MSK-FI was higher in patients who had a Karnofsky performance status of poor, a lower walking speed, limited social activity, taking five or more drugs compared to patients without any violations in these areas.
In multivariate analysis, each increase of 1 point scale MSK-FI was associated with a longer duration of stay and a higher likelihood of admission to the NICU. Each increase points on MSK-FI scale of 1 point was also associated with a higher risk of death within 1 year after surgery.
"We also evaluated the relationship between the MSK-FI and geriatric assessment (which is the standard definition of weakness) and found that these two factors are closely related to each other", - says Shahrokni.
Next Steps study - assessment of the reliability of MSK-FI, especially in small hospitals and institutions with limited resources, and evaluation of the relationship between the MSK-FI and the state more homogeneous groups of patients (eg, patients with pancreatic cancer ). In addition, the need for more specific information about the passage of time and treatment.
The team develops a very short questionnaire indicators of weakness based on geriatric assessment and MSK-FI, which can serve as a tool for rapid assessment of weakness.
Elizabeth George, MD, and Shipra Arya, MD of the hospital and clinics at Stanford University in California, noted that the weakness is an independent risk factor for adverse outcomes after surgery. "Over the past decade, it has developed a number of prospective screening tools, and much has been done to assess the patients as the weakness of poor outcome after surgery," - they say. - We strive to incorporate analysis of fatigue in everyday clinical practice, and electronic medical records. "