Screening for frailty among older patients with cancer that qualify for abdominal surgery

Kenig, Jakub; Żychiewicz, Beata; Olszewska, Urszula; Richter, Piotr

doi:10.1016/j.jgo.2014.09.179

Cited by 61 publications

(80 citation statements)

References 31 publications

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“…An alternative could be the use of short and validated screening tools. In our previous study evaluating eight screening test for frailty (the same as in the present study with addition of abbreviated Comprehensive Geriatric AssessmentaCGA), we observed that the aCGA and G8 were the best screens for older patients with cancer that qualified for elective abdominal surgery; the G8 had the highest sensitivity and negative predictive value and the aCGA was a good overall assessment tool (Kenig, Zychiewicz, Olszewska, & Richter, 2014). In the present study, G8 also had the highest sensitivity and acceptable negative predictive value but was not as good as the VES-13, what was not the case in elective cancer patients.…”

Section: Discussionsupporting

confidence: 51%

“…However, in case of emergency surgical patients with and without cancer we did not observed difference in their discriminatory ability. Of note is that in the previous study we compared the results with the full Geriatric Assessment, as a reference test, and not with the truth outcome factors such as morbidity and mortality (Kenig et al, 2014). We decided also not to include the aCGA at present due to incomplete data in some patients (mainly in points evaluating cognition what turned to be technically very difficult in emergency admitted patients).…”

Section: Discussionmentioning

confidence: 99%

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Six screening instruments for frailty in older patients qualified for emergency abdominal surgery

Kenig

Żychiewicz

Olszewska

et al. 2015

Archives of Gerontology and Geriatrics

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Six screening instruments for frailty in older patients qualified for emergency abdominal surgery

Kenig

Żychiewicz

Olszewska

et al. 2015

Archives of Gerontology and Geriatrics

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“…Participants were most commonly sampled from the Netherlands (29 of 95 studies) 27,58–60,66,74,75,82,84–90,93,94,96,99,100,105,109,111–113,123–126 . The cohorts were predominantly community based generally older adult populations (51 of 95) 3,9,27,40,44,46,48,54–56,58–60,65,67,68,72,74,75,77,79,80,82–86,88,93–97,101,103,104,106,107,109,116,117,121–130 . Only one of the 95 cohorts consisted of “psychogeriatric patients” (80.8% diagnosed with dementia, 5% depression, 11% unspecified, 3% no mental disorder) .…”

Section: Resultsmentioning

confidence: 99%

“…Hypothesis testing had the greatest number of fair ratings (65 of 70). A total of 42 of 95 studies had at least one aspect of methodological quality rated as poor 41,44–48,50,51,55,56,58,59,61,63,66–68,74,76–78,80,82,84–86,89,96–98,102,103,106,109,110,113,116,117,119,124,127,128 . Criterion validity had the greatest number of poor ratings (30 of 42).…”

Section: Resultsmentioning

confidence: 99%

“…3,9,26,27, The most frequently observed study design was prospective cohort (32 of 95 studies). 3,9,[40][41][42][43][44][46][47][48][49]57,[68][69][70]72,73,78,80,84,87,89,92,95,97,101,105,107,114,116,129,130 Of the 62 studies with follow-up data available, follow-up periods ranged from 1 month 51,62,71 to 348 months. 117 The total number of participants per study ranged from 14 119 to 931 541.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Multicomponent Frailty Assessment Tools for Older People with Psychiatric Disorders: A Systematic Review

Sutton

Gould

Coulson

et al. 2018

J American Geriatrics Society

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Objective To review evidence evaluating the use of multicomponent frailty assessment tools in assessing frailty in older adults with psychiatric disorders. Methods A systematic literature review was conducted to identify all multicomponent frailty assessment tools (ie, a tool that assesses two or more indicators of frailty). The items of each frailty assessment tool were compared with Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‐5) diagnostic criteria for psychiatric disorders to assess construct overlap. Studies conducted in community, inpatient, and outpatient clinical settings were considered for inclusion. Participants Adults aged 60 years or older. Results A total of 5639 records were identified following the removal of duplicates, from which 95 studies were included for review. Of the 48 multicomponent frailty assessment tools identified, no tool had been developed for, or validated in, older adult populations with a psychiatric disorder. Overall, 20 of 48 frailty assessment tools contained a psychological assessment domain, with 17 of 48 tools citing the presence of depressed mood and/or anxiety as a frailty indicator. Common areas of construct overlap in frailty assessment tools and DSM‐5 diagnostic criteria included weight loss (29 of 48) and fatigue (21 of 48). Conclusions Significant construct overlap exists between the indicators of frailty as conceptualized in existing frailty assessment tools and DSM‐5 diagnostic criteria for common psychiatric disorders including major depressive episode and generalized anxiety disorder that has the potential to confound frailty assessment results. Further research is necessary to establish a reliable and valid tool to assess frailty in this population. J Am Geriatr Soc 67:1085–1095, 2019.

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Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment

et al. 2021

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IMPORTANCEOlder adults with cancer are at risk of overtreatment or undertreatment when decision-making is based solely on chronological age. Although a geriatric assessment is recommended to inform care, the time and expertise required limit its feasibility for all patients. Screening tools offer the potential to identify those who will benefit most from a geriatric assessment. Consensus about the optimal tool to use is lacking.OBJECTIVE To appraise the evidence on screening tools used for older adults with cancer and identify an optimal screening tool for older adults with cancer who may benefit from geriatric assessment.EVIDENCE REVIEW Systematic review of 4 databases (MEDLINE, Embase, CINAHL [Cumulative Index to Nursing and Allied Health Literature], and PubMed) with narrative synthesis from January 1, 2000, to March 14, 2019. Studies reporting on the diagnostic accuracy and use of validated screening tools to identify older adults with cancer who need a geriatric assessment were eligible for inclusion. Data were analyzed from March 14, 2019, to March 23, 2020.FINDINGS Seventeen unique studies were included, reporting on the use of 12 screening tools. Most studies were prospective cohort studies (n = 11) with only 1 randomized clinical trial. Not all studies reported time taken to administer the screening tools. The Geriatric-8 (G8) (n = 12) and the Vulnerable Elders Survey-13 (VES-13) (n = 9) were the most frequently evaluated screening tools. The G8 scored better in sensitivity and the VES-13 in specificity. Other screening tools evaluated include the Groningen Frailty Index, abbreviated comprehensive geriatric assessment, and Physical Performance Test in 2 studies each. All other screening tools were evaluated in 1 study each. CONCLUSIONS AND RELEVANCETo date, the G8 and VES-13 have the most evidence to recommend their use to inform the need for geriatric assessment. When choosing a screening tool, clinicians will need to weigh the tradeoffs between sensitivity and specificity. Future research needs to further validate or improve current screening tools and explore other factors that can influence their use, such as ease of use and resourcing.

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Screening for frailty among older patients with cancer that qualify for abdominal surgery

Cited by 61 publications

References 31 publications

Six screening instruments for frailty in older patients qualified for emergency abdominal surgery

Six screening instruments for frailty in older patients qualified for emergency abdominal surgery

Multicomponent Frailty Assessment Tools for Older People with Psychiatric Disorders: A Systematic Review

Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment

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