Hospitalization-associated disability prediction using Hospital Frailty Risk Score in older patients undergoing pancreatectomy

Tatsuro Inoue; Ryo Momosaki; Akio Shimizu; Keisuke Maeda

doi:10.1007/s41999-023-00928-1

Hospitalization-associated disability prediction using Hospital Frailty Risk Score in older patients undergoing pancreatectomy

Eur Geriatr Med. 2024 Feb 10. doi: 10.1007/s41999-023-00928-1. Online ahead of print.

Authors

Tatsuro Inoue¹, Ryo Momosaki², Akio Shimizu³, Keisuke Maeda^{4

5}

Affiliations

¹ Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan. tatsuro-inoue@nuhw.ac.jp.
² Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Mie, 514-8507, Japan.
³ Department of Food and Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, 380-8525, Japan.
⁴ Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi, 474-0031, Japan.
⁵ Nutrition Therapy Support Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.

PMID: 38340283
DOI: 10.1007/s41999-023-00928-1

Abstract

Purpose: Frailty and hospitalization-associated disabilities (HAD) are geriatric conditions that should be managed in older patients undergoing pancreatectomy. The Hospital Frailty Risk Score (HFRS) can evaluate frailty based on medical records and could predict postoperative activities of daily living (ADL) decline. This study aimed to investigate whether HFRS affects the postoperative incidence of HAD in older patients who underwent pancreatectomy.

Methods: This retrospective, observational study used data from a nationwide hospital-based database. We included consecutive patients aged ≥ 65 years who were diagnosed with pancreatic cancer (International Statistical Classification of Diseases, 10th revision code C25) and underwent curative pancreatectomy between April 2014 and August 2020. We evaluated preoperative frailty using HFRS. The primary outcome was HAD following pancreatectomy. Logistic regression analysis was performed for analyzing the impact of frailty on HAD following pancreatectomy.

Results: We included 671 patients for the analysis (mean age 74.3 ± 5.6, male 54.8%). The prevalence of intermediate and high risk of frailty with HFRS ≥ 5 was 2.7%. The incidence of HAD was significantly higher in the intermediate- and high-risk groups compared to that in the low-risk group (33.3% vs. 8.4%, p < 0.001). Logistic regression analysis demonstrated that intermediate and high risks of frailty increased the likelihood of HAD (odds ratio, 3.55; 95% confidence interval: 1.12-11.2).

Conclusions: The risk of frailty evaluated using the HFRS increased the likelihood of developing HAD in older patients undergoing pancreatectomy. Future research on effective perioperative interventions for preventing postoperative HAD and enhancing postoperative ADL recovery is warranted.

Keywords: Activities of daily living; Aged; Cancer; Pancreatic neoplasms.