How can we approach preoperative frailty and related factors in patients with cancer? A scoping review.
Misun Jeon, Sang Hwa Lee, Ji Yoon Jang and 1 others
PMID 38890786WHAT IT FOUND
Preoperative frailty was often linked to more complications, longer stays, higher mortality, readmission and lower survival after cancer surgery, but 34 different tools were used and no single measure was clearly best.
Key findings
01No single frailty measure stood out: 34 tools were used, with Fried's frailty phenotype and the modified Frailty Index most common.
02Preoperative frailty was significantly associated with worse postoperative outcomes, including complications, longer hospital stay, mortality, readmission and lower survival.
03Only 10 of 24 studies examined physical status, and 70% reported a significant association between frailty and physical status.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a scoping review, not a test of whether frailty screening or any intervention improves cancer surgery outcomes. No quality appraisal was done, and the search covered only four databases, English articles, and January 2011 to April 2021, so other evidence may be missing. Most included studies were observational; only 4.2% were randomized trials, so associations may not mean frailty caused the outcome. Frailty measurement was very heterogeneous: 34 tools were used, some with different items under the same name, and no tool was clearly best. Only 10 of 24 studies examined physical status, and findings were mixed for some factors such as cancer stage.
Declared interests
The supplied article text does not include a conflicts or funding statement; the publication type notes non-U.S. government research support.
The easy way to misread this
Do not read these associations as proof that frailty causes bad outcomes or that using one frailty tool will improve postoperative care. Most included studies were observational, and the review did not test whether screening changes outcomes.