Introduction: Frailty represents a complex geriatric syndrome associated with elevated
rates of postoperative complications as shown for several malignant entities, including head and neck
cancer. A specific screening instrument to assess frailty in head and neck patients does not exist. Both
the FRAIL Scale and the G8 questionnaire are well-established and easy to use as screening tools. The
present study’s aim was to assess the potential of frailty screening to predict postoperative complications in head and neck patients prior to surgery. Patients and methods: We recorded demographic
data, pre-existing medical conditions and clinical characteristics in a prospective cohort of 104 head
and neck cancer patients undergoing major head and neck surgery and assessed frailty prospectively
on the day of admission utilizing the G8 questionnaire and the FRAIL Scale. We analyzed the link
between occurrence of postoperative complications up to the twenty-first postoperative day and
age, frailty and other covariates using χ
2
tests and receiver operating characteristic (ROC) curves.
Results: There was no significant correlation between patients’ pre-existing medical conditions and
postoperative complications. Whereas chronological age alone did not predict the occurrence of
postoperative complications, frailty posed the highest risk for complications. Frailty according to
either the G8 questionnaire or the FRAIL Scale predicted occurrence of complications with an area
under the curve (AUC) of 0.64 (p = 0.018) and 0.62 (p = 0.039) and severe complications with an AUC
of 0.72 (p = 0.014) and 0.69 (p=0.031), respectively. Neither frailty score correlated with age or with
each other. Conclusion: Prospective screening using the FRAIL Scale or the G8 questionnaire reliably
detected frailty in our sample group. Frailty is linked to increased risk of postoperative complications.
The correct prediction of severe postoperative complications as shown identifies vulnerable cases and
triggers awareness of potential complications. Anticipating risk allows for a more comprehensive
view of the patient and triggers decision making towards risk adjustment, and therefore a selective
view of alternative treatment modalities.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:88427 |
| Date | 04 December 2023 |
| Creators | Kunz, Viktor, Wichmann, Gunnar, Wald, Theresa, Pirlich, Markus, Zebralla, Veit, Dietz, Andreas, Wiegand, Susanne |
| Publisher | MDPI |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2077-0383, 10.3390/jcm11164714 |
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