Application value of different frailty assessment tools in older patients undergoing major abdominal surgery
Background: Multiple frailty assessment tools are available for clinical practice, but the optimal tool remains unclear. This study aimed to compare the diagnostic performance of frail scale (FS), frailty phenotype (FP),11-item modified frailty index (mFI-11), Edmonton Frail Scale (EFS), and Tilburg...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-10-01
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| Series: | Experimental Gerontology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0531556525001810 |
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| author | Junli You Xuepiao Chen Yu Rong Sining Pan Tianxiao Liu Yubo Xie |
| author_facet | Junli You Xuepiao Chen Yu Rong Sining Pan Tianxiao Liu Yubo Xie |
| author_sort | Junli You |
| collection | DOAJ |
| description | Background: Multiple frailty assessment tools are available for clinical practice, but the optimal tool remains unclear. This study aimed to compare the diagnostic performance of frail scale (FS), frailty phenotype (FP),11-item modified frailty index (mFI-11), Edmonton Frail Scale (EFS), and Tilburg Frailty Indicator (TFI) for frailty taking the comprehensive geriatric assessment (CGA) as the gold standard, and their ability to predict 30-day postoperative complications and prolonged length of stay (PLOS). Methods: This study recruited older patients (≥ 65 years) undergoing elective major abdominal surgery. The receiver operating characteristic (ROC) curves, technique for order preference by similarity to ideal solution (TOPSIS), and decision analysis curve (DCA) were used to validate the diagnostic, comprehensive, and predictive performance of 5 tools in frailty, complications, and PLOS. Results: EFS presented moderate consistency with CGA (Kappa = 0.544, P < 0.001), excellent performance in diagnosing frailty (area under the ROC curve (AUC) = 0.881, P < 0.001), and high clinical net benefit within the risk threshold ranging from 0.8 % to 57.44 %. Although EFS had the largest AUC for predicting complications (AUC = 0.612) and PLOS (AUC = 0.642) and showed high clinical net benefit, its predictive performance was poor (AUC < 0.7). The TOPSIS indicated that EFS required optimization in multiple aspects (closeness coefficient (Ci) < 0.8). Conclusion: EFS has excellent diagnostic performance and clinical net benefit for frailty. However, further research is required to identify optimal tools or combine EFS with additional indicators to enhance its comprehensive and predictive performance for complications and PLOS. |
| format | Article |
| id | doaj-art-415f2a4c44c34a19bb9536e1d966de5e |
| institution | Kabale University |
| issn | 1873-6815 |
| language | English |
| publishDate | 2025-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Experimental Gerontology |
| spelling | doaj-art-415f2a4c44c34a19bb9536e1d966de5e2025-08-20T03:33:04ZengElsevierExperimental Gerontology1873-68152025-10-0120911285210.1016/j.exger.2025.112852Application value of different frailty assessment tools in older patients undergoing major abdominal surgeryJunli You0Xuepiao Chen1Yu Rong2Sining Pan3Tianxiao Liu4Yubo Xie5Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China; Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China; Corresponding author at: Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.Background: Multiple frailty assessment tools are available for clinical practice, but the optimal tool remains unclear. This study aimed to compare the diagnostic performance of frail scale (FS), frailty phenotype (FP),11-item modified frailty index (mFI-11), Edmonton Frail Scale (EFS), and Tilburg Frailty Indicator (TFI) for frailty taking the comprehensive geriatric assessment (CGA) as the gold standard, and their ability to predict 30-day postoperative complications and prolonged length of stay (PLOS). Methods: This study recruited older patients (≥ 65 years) undergoing elective major abdominal surgery. The receiver operating characteristic (ROC) curves, technique for order preference by similarity to ideal solution (TOPSIS), and decision analysis curve (DCA) were used to validate the diagnostic, comprehensive, and predictive performance of 5 tools in frailty, complications, and PLOS. Results: EFS presented moderate consistency with CGA (Kappa = 0.544, P < 0.001), excellent performance in diagnosing frailty (area under the ROC curve (AUC) = 0.881, P < 0.001), and high clinical net benefit within the risk threshold ranging from 0.8 % to 57.44 %. Although EFS had the largest AUC for predicting complications (AUC = 0.612) and PLOS (AUC = 0.642) and showed high clinical net benefit, its predictive performance was poor (AUC < 0.7). The TOPSIS indicated that EFS required optimization in multiple aspects (closeness coefficient (Ci) < 0.8). Conclusion: EFS has excellent diagnostic performance and clinical net benefit for frailty. However, further research is required to identify optimal tools or combine EFS with additional indicators to enhance its comprehensive and predictive performance for complications and PLOS.http://www.sciencedirect.com/science/article/pii/S0531556525001810FrailtyAgedDiagnostic performancePredictive performance |
| spellingShingle | Junli You Xuepiao Chen Yu Rong Sining Pan Tianxiao Liu Yubo Xie Application value of different frailty assessment tools in older patients undergoing major abdominal surgery Experimental Gerontology Frailty Aged Diagnostic performance Predictive performance |
| title | Application value of different frailty assessment tools in older patients undergoing major abdominal surgery |
| title_full | Application value of different frailty assessment tools in older patients undergoing major abdominal surgery |
| title_fullStr | Application value of different frailty assessment tools in older patients undergoing major abdominal surgery |
| title_full_unstemmed | Application value of different frailty assessment tools in older patients undergoing major abdominal surgery |
| title_short | Application value of different frailty assessment tools in older patients undergoing major abdominal surgery |
| title_sort | application value of different frailty assessment tools in older patients undergoing major abdominal surgery |
| topic | Frailty Aged Diagnostic performance Predictive performance |
| url | http://www.sciencedirect.com/science/article/pii/S0531556525001810 |
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