title: Frailty: an outcome predictor for elderly gynecologic oncology patients.
abstract: OBJECTIVE
  The objective of this pilot study was to determine if frailty predicts surgical complications among elderly women undergoing gynecologic oncology procedures.
  
  
  METHODS
  A cohort of gynecologic oncology patients age ≥ 65, undergoing surgery between March and December 2011 was identified. Frailty was evaluated using a validated assessment tool. The primary outcome measure was 30 day postoperative complication rate.
  
  
  RESULTS
  Forty women were approached for study entry and 37 (92%) enrolled. The mean age was 73 years (range 65-95). The majority of women had a malignancy and underwent a major abdominal surgical procedure. Twenty-one women (57%) were not frail, 10 (27%) were intermediately frail and 6 (16%) were frail. There was no difference in age or prevalence of medical comorbidities between groups. Frail women had a significantly higher BMI compared to intermediately frail and not frail women, (36.0, 31.5 and 26.1 kg/m(2), p=0.02). The rate of 30-day surgical complications increased with frailty score and was 24%, versus 67% for women who were not frail as compared to the frail (p=0.04).
  
  
  CONCLUSIONS
  Pre-operative frailty assessment is well accepted by gynecologic oncology patients and feasible in a clinic setting. Frail women had a higher BMI, indicating that low body weight is not a marker for frailty, and had a significantly higher rate of 30-day postoperative complications in this pilot study. Initial findings support the concept of measuring frailty as a possible predictor for postoperative morbidity that will allow for improved patient counseling and decision making.
authors.affiliation: Thornton Gynecology Oncology Service, Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, VA 22908, USA. mbc3fm@virginia.edu
authors.forename: Madeleine
authors.initials: M
authors.lastname: Courtney-Brooks
authors.forename: A Rauda
authors.initials: AR
authors.lastname: Tellawi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Scalici
authors.forename: Linda R
authors.initials: LR
authors.lastname: Duska
authors.forename: Amir A
authors.initials: AA
authors.lastname: Jazaeri
authors.forename: Susan C
authors.initials: SC
authors.lastname: Modesitt
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Cantrell
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D005833:Genital Neoplasms, Female / Q000601:surgery*; D015577:Geriatric Assessment; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D012307:Risk Factors