The multidimensional frailty score based on comprehensive geriatric assessment is more useful than conventional methods for predicting outcomes in geriatric patients undergoing surgery.
We performed a retrospective review of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) examination to determine the prevalence of thyroid FDG-PET incidentaloma in a patient group evaluated for metastasis of cancer and in a group of healthy subjects who underwent voluntary cancer screening. We also evaluated the risk of malignancy in focal thyroid FDG-PET incidentaloma and its association with standard uptake values (SUVs) (maximum and greater than 0.75 threshold). A total of 1330 subjects underwent FDG-PET for metastasis evaluation (n = 999) and cancer screening (n = 331). Twenty-nine of 1330 subjects (2.2%) showed focal (n = 21) or diffuse (n = 8) thyroid FDG-PET incidentaloma. There was no significant difference in the prevalence of thyroid FDG-PET incidentaloma between the two groups (19 of 999 vs. 10 of 331; P > 0.05). Four of 15 focal incidentalomas (26.7%) whose histological diagnoses were available showed papillary thyroid cancer. The maximum SUV (16.5 +/- 4.70) and greater than 0.75 threshold SUV (14.2 +/- 5.3) of malignant lesions were significantly higher than those of benign tumors (6.5 +/- 3.8 and 4.9 +/- 3.0; P < 0.05). In conclusion, thyroid FDG-PET incidentaloma has prevalence of 2.2%, and its prevalence was not different according to the purpose of the FDG-PET. The focal thyroid FDG-PET incidentaloma carries a high risk of malignancy, especially in cases with high SUVs. Therefore, focal thyroid FDG-PET incidentaloma with high SUVs warrants a pathological diagnostic procedure if it changes a patient's treatment plan or prognosis.
Background/Aims:The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale is a screening tool for frailty status using a simple 5-item questionnaire. The aim of this study was to evaluate the clinical feasibility and validity of the Korean version of the FRAIL (K-FRAIL) scale.Methods:Questionnaire items were translated and administered to 103 patients aged ≥ 65 years who underwent a comprehensive geriatric assessment at the Seoul National University Bundang Hospital. In this cross-sectional study, the K-FRAIL scale was compared with the domains and the multidimensional frailty index of the comprehensive geriatric assessment. We also assessed the time required to complete the scale.Results:The participants’ mean age was 76.8 years (standard deviation [SD], 6.1), and 55 (53.4%) were males. The mean overall frailty index was 0.19 (SD, 0.17). For K-FRAIL-robust, prefrail, and frail patients, the mean frailty indices were 0.09, 0.18, and 0.34, respectively (p for trend < 0.001). A higher degree of impairment in the K-FRAIL scale was associated with worse nutritional status, poor physical performance, functional dependence, and polypharmacy. The number of items with impairment in the K-FRAIL scale was positively associated with the frailty index (B = 3.73, p < 0.001). The K-FRAIL scale could differentiate vulnerability from robustness with a sensitivity of 0.90 and a specificity of 0.33. Of all patients, 75 (72.8%) completed the K-FRAIL scale within < 3 minutes.Conclusions:The K-FRAIL scale is correlated with the frailty index and is a simple tool to screen for frailty in a clinical setting.
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