Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery
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 FR...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4714 |
| _version_ | 1797432130326757376 |
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| author | Viktor Kunz Gunnar Wichmann Theresa Wald Markus Pirlich Veit Zebralla Andreas Dietz Susanne Wiegand |
| author_facet | Viktor Kunz Gunnar Wichmann Theresa Wald Markus Pirlich Veit Zebralla Andreas Dietz Susanne Wiegand |
| author_sort | Viktor Kunz |
| collection | DOAJ |
| description | 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<sup>2</sup> 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 (<i>p</i> = 0.018) and 0.62 (<i>p</i> = 0.039) and severe complications with an AUC of 0.72 (<i>p</i> = 0.014) and 0.69 (<i>p</i>=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. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T09:55:51Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ea072c9c00404478bbd0b88c13e0b0922023-12-01T23:50:08ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116471410.3390/jcm11164714Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck SurgeryViktor Kunz0Gunnar Wichmann1Theresa Wald2Markus Pirlich3Veit Zebralla4Andreas Dietz5Susanne Wiegand6Department of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, 04103 Leipzig, GermanyIntroduction: 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<sup>2</sup> 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 (<i>p</i> = 0.018) and 0.62 (<i>p</i> = 0.039) and severe complications with an AUC of 0.72 (<i>p</i> = 0.014) and 0.69 (<i>p</i>=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.https://www.mdpi.com/2077-0383/11/16/4714head and neck surgeryfrailtyG8 questionnaireFRAIL Scalepostoperative complicationshead and neck squamous cell carcinoma |
| spellingShingle | Viktor Kunz Gunnar Wichmann Theresa Wald Markus Pirlich Veit Zebralla Andreas Dietz Susanne Wiegand Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery Journal of Clinical Medicine head and neck surgery frailty G8 questionnaire FRAIL Scale postoperative complications head and neck squamous cell carcinoma |
| title | Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery |
| title_full | Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery |
| title_fullStr | Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery |
| title_full_unstemmed | Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery |
| title_short | Frailty Assessed with FRAIL Scale and G8 Questionnaire Predicts Severe Postoperative Complications in Patients Receiving Major Head and Neck Surgery |
| title_sort | frailty assessed with frail scale and g8 questionnaire predicts severe postoperative complications in patients receiving major head and neck surgery |
| topic | head and neck surgery frailty G8 questionnaire FRAIL Scale postoperative complications head and neck squamous cell carcinoma |
| url | https://www.mdpi.com/2077-0383/11/16/4714 |
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