A deficit-accumulation frailty index predicts survival outcomes in patients with gynecologic malignancy

• Published in: Gynecologic oncology 2021-06, Vol.161 (3), p.700-704
• Main Authors: Mullen, Mary M., McKinnish, Tyler R., Fiala, Mark A., Zamorano, Abigail S., Kuroki, Lindsay M., Fuh, Katherine C., Hagemann, Andrea R., McCourt, Carolyn K., Mutch, David G., Powell, Matthew A., Wildes, Tanya M., Thaker, Premal H.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cohort Studies; Databases, Factual; Ethnicity; Female; Frail Elderly; Frailty; Genital Neoplasms, Female - ethnology; Genital Neoplasms, Female - mortality; Humans; Medicare; Predictive Value of Tests; Proportional Hazards Models; Retrospective Studies; SEER Program; Survival Analysis; United States
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2021.02.027

To determine the association between scores from a 25-item patient-reported Rockwood Accumulation of Deficits Frailty Index (DAFI) and survival outcomes in gynecologic cancer patients. A frailty index was constructed from the SEER-MHOS database. The DAFI was applied to women age ≥ 65 diagnosed with all types of gynecologic cancers between 1998 and 2015. The impact of frailty status at cancer diagnosis on overall survival (OS) was analyzed using Kaplan-Meier curves and Cox proportional hazards regression. In this cohort (n = 1336) the median age at diagnosis was 74 (range 65–97). Nine hundred sixty-two (72%) women were Caucasian and 132 (10%) were African-American. Overall, 651(49%) of patients were considered frail. On multivariate analysis, frail patients had a 48% increased risk for death (aHR 1.48; 95% CI 1.29–1.69; P