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. 2024 Sep 30:11:1466366.
doi: 10.3389/fmed.2024.1466366. eCollection 2024.

The Edmonton Frail Scale as a screening score for frailty in oncogeriatrics

Julia De Schrevel  1 , Clémentine Faucon  1 , François-Xavier Sibille  2   3 , Laura Dumont  4 , Francois R Herrmann  5 , Héloïse Rouvière  1 , Sandra De Breucker  1   5
Affiliations

The Edmonton Frail Scale as a screening score for frailty in oncogeriatrics

Julia De Schrevel et al. Front Med (Lausanne). .

Abstract

Introduction: The comprehensive geriatric assessment (CGA) is recommended for assessing frailty in older cancer patients but is time-consuming. The G8 screening tool was developed to select frail patients requiring CGA to optimize resources. The Edmonton Frail Scale (EFS) is another frailty scale validated for preoperative frailty screening, but scarcely studied in the field of oncogeriatrics. In this study, we examined the added value of the EFS in older cancer patients already considered as frail by the G8, by analyzing the association of EFS with CGA adjusted for age, gender, metastatic stage and comorbidity. We also analyzed the association of EFS with the one-year mortality rate after adjusting for cancer type and metastatic stage.

Methodology: This retrospective study included patients aged over 70 years old with a new diagnosis of cancer, considered as potentially frail according to the G8 and who had had a CGA (N = 380).

Results: The EFS identified 329 (86.58%) patients as frail and having a statistically significant predicted number of pathological components on the CGA (r = 0.64, p < 0.001). When adjusted for age, sex, comorbidity, and metastatic stage, the EFS was independently associated with the CGA (p < 0001), as well as with comorbidity (p = 0.004). The patients who died in the first year (43%) had a significantly higher mean EFS score (8/17) than living patients (6/17) (p < 0.0001). After adjustment for cancer type and stage, EFS independently predicted one-year mortality (OR 1.17; 95% CI 1.08-1.28; pseudo R 2 = 0.228, p < 0.001).

Discussion: The EFS is a reliable tool for predicting frailty identified by the CGA in an older cancer population pre-selected as frail by the G8. EFS is an independent predictor of one-year mortality after adjustment for confounding factors. Validation of the EFS as a screening tool for frailty in cancer requires further studies to assess its performance in patients with normal G8 scores.

Keywords: Edmonton Frail Scale; cancer; comprehensive geriatric assessment; frailty; oncogeriatrics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for patient inclusion and exclusion.
Figure 2
Figure 2
ROC curve comparing Edmonton Frail Scale with the gold standard (CGA).
Figure 3
Figure 3
Pearson’s correlation between the EFS and the number of pathological domains in the CGA.
Figure 4
Figure 4
Pearson’s correlation between the EFS and the G8 score.
See this image and copyright information in PMC

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References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. . Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. (2021) 71:209–49. doi: 10.3322/caac.21660 - DOI - PubMed
    1. Pilleron S, Sarfati D, Janssen-Heijnen M, Vignat J, Ferlay J, Bray F, et al. . Global cancer incidence in older adults, 2012 and 2035: a population-based study. Int J Cancer. (2019) 144:49–58. doi: 10.1002/ijc.31664, PMID: - DOI - PubMed
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. (2013) 381:752–62. doi: 10.1016/S0140-6736(12)62167-9, PMID: - DOI - PMC - PubMed
    1. Hamaker ME, Prins MC, Stauder R. The relevance of a geriatric assessment for elderly patients with a haematological malignancy—a systematic review. Leuk Res. (2014) 38:275–83. doi: 10.1016/j.leukres.2013.12.018, PMID: - DOI - PubMed
    1. Dale W, Mohile SG, Eldadah BA, Trimble EL, Schilsky RL, Cohen HJ, et al. . Biological, clinical, and psychosocial correlates at the interface of cancer and aging research. JNCI J Natl Cancer Inst. (2012) 104:581–9. doi: 10.1093/jnci/djs145, PMID: - DOI - PMC - PubMed

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