Psychometric properties of the hematopoietic cell transplantation frailty scale: A prospective observational study

Frailty is common in patients undergoing hematopoietic stem cell transplantation, thereby increasing toxicity risk and reducing post-transplant survival. This study evaluated the psychometric properties of the Hematopoietic Cell Transplantation Frailty Scale to assess transplant candidates. Additionally, it characterized the participants` sociodemographic and clinical profiles.

One hundred and two patients with hematologic malignancies participated in the study. Reliability was evaluated through internal consistency (Cronbach's alpha), factorial analysis with varimax rotation, and construct validity via hypothesis testing. Scale items were grouped in three dimensions: (1) objective, (2) subjective, and (3) laboratory parameter assessments.

Participants had a mean age of 40.5 ± 14.5 years; 15 (14.7%) were classified as 'frail,' 48 (47.1%) as 'pre-frail,' and 39 (38.2%) as 'fit.' Multiple myeloma was the most common diagnosis (32.4%). Internal consistency was acceptable (α = 0.63). The first dimension explained 55.3% of the variance, while the second contributed 31.5%, totaling 86.8% of the explained variance. Construct validity confirmed only one hypothesis: patients with a performance status below 90 had significantly higher frailty scores than those with a performance status of 90-100 (p-value <0.01). Other hypotheses comparing frailty classification (frail, pre-frail, and fit) across Disease Risk Index categories (low-moderate, high-very high, not evaluable), Hematopoietic Cell Transplantation Comorbidity Index (<3, ≥3), transplant type (autologous, allogeneic), and age groups (18-59, ≥ 60 years) were rejected (p-value >0.05).

The Chilean version of the Hematopoietic Cell Transplantation Frailty Scale demonstrates adequate reliability and validity, supported by a strong factorial structure to assess transplant candidates. Frailty was associated with a lower performance status, but not with the Disease Risk Index, the Comorbidity Index, transplant type or age.