The Hospital Frailty Risk Score and outcomes in head and neck cancer surgery

Area of Science:

• Geriatric Medicine
• Surgical Oncology
• Health Services Research

Background:

• Head and neck cancer surgeries are complex procedures often performed on older adults.
• Assessing patient frailty is crucial for predicting surgical outcomes and guiding clinical decisions.
• The Hospital Frailty Risk Score (HFRS) is a validated tool for measuring frailty in hospitalized patients.

Purpose of the Study:

• To evaluate the predictive capability of the Hospital Frailty Risk Score (HFRS) for outcomes in elderly patients undergoing head and neck procedures.
• To investigate the association between HFRS-defined frailty levels and key postoperative outcomes.

Main Methods:

• Retrospective cohort study utilizing data from the NHS Secondary Uses Service (SUS) electronic database (April 2008 - February 2020).
• Included 7479 patients aged 75 years and above admitted for head and neck cancer procedures.
• Risk-stratified 5153 patients into mild, moderate, and severe frailty groups based on HFRS.

Main Results:

• Severely frail patients experienced a significantly longer median length of stay (9 days) compared to mildly frail patients (3 days).
• Twenty-seven percent of severely frail patients faced 30-day readmission.
• Higher frailty levels correlated with increased short-term and long-term mortality risk, with 50% of moderately frail and 66% of severely frail patients dying by study end.

Conclusions:

• The HFRS is a valuable tool for quantifying the relationship between frailty and adverse health outcomes in older adults undergoing head and neck surgery.
• Findings support the use of HFRS for identifying patients who may benefit from holistic assessments, improving prognostication, and informing service planning.