Garcia CA, et al. - In this study, researchers examined frailty assessment utilizing the Risk Assessment Index (RAI) in patients with cancer and its ability to forecast hospital utilization and 90-day mortality. They found that the RAI may, indeed, be utilized to predict 90-day mortality in this patient population. Patients at greatest risk of 90-day mortality were more likely to have unplanned hospitalizations. The investigators also noted a statistically significant difference in RAI scores between patients with and without unplanned emergency department (ED) visits/hospitalizations. However, this difference was too small to be clinically meaningful. Melanoma, prostate, and lung were the most common cancer types found in this investigation.

Methods

• New patients with solid tumor malignancies at the UPMC Hillman Cancer Center completed the RAI from September 15, 2017 to January 31, 2018.
• Thereafter, the investigators abstracted age, cancer type and stage, and treatments.
• The Wolff Center at UPMC provided data on ED visits, hospitalizations and mortality for analysis.
• Researchers performed Mann-Whitney U and likelihood-ratio tests to compare RAI, ED usage/hospitalizations, and mortality.
• They excluded elective hospital admissions.

Results

• A total of 273 patients completed the RAI.
• The researchers noted that 58.6% of patients were male, the average age was 62.7 years (range: 21-88 years), and the average RAI score was 39.9 (IQR: 35-44).
• Melanoma (22.7%), prostate (14.3%), and lung (11.4%) were the most common cancer types.
• A total of 43.6% of patients had stage IV cancer.
• Within 90 days following RAI, 51 (18.7%) patients experienced ≥ 1 unplanned ED visit or hospitalization, and 10 patients (3.7%) were deceased.
• Findings revealed that patients with an ED visit/hospitalization had an average RAI of 42 (IQR: 37-46) vs 39.4 (IQR: 35-43) for patients without one—a 2.6-point difference (P=0.008).
• The investigators discovered that 90-day mortalities had an average RAI score of 47.5 (IQR 42-53) vs 39.6 (IQR 35-44) for non-mortalities—a 7.9-point difference (P=0.003).
• A total of 6 of 242 (2.5%) patients without a hospitalization experienced mortality vs 4 of 31 (12.9%) with hospitalization who experienced mortality (P=0.017).