Computer Science Department, Stanford University, Stanford, CA, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Eur J Surg Oncol. 2023 Mar;49(3):662-666. doi: 10.1016/j.ejso.2022.11.011. Epub 2022 Nov 8.
The aim of this study was to assess the degree to which patient frailty is associated with both need for assistance and time required to complete the eRFA, a web-based GA tool.
We retrospectively identified patients who underwent surgery for cancer from 2015 to 2020, had a hospital length of stay ≥1 day, and completed the eRFA before surgery. Frailty was assessed using two methods: the MSK-FI (score 0-11) and the AGD (score 0-13). Time to complete the eRFA was automatically recorded by a web-based tool; assistance with eRFA completion was self-reported by the patient.
In total, 3456 patients were included (median age, 78 years). Overall, 58% of surveys were completed without assistance, 30% were completed with assistance, and 12% were completed by someone other than the patient. Younger age (median age: without assistance, 77 years; with assistance, 80 years; completed by someone else, 80 years) and lower frailty score (median AGD: 4, 6, and 8, respectively; median MSK-FI: 2, 3, and 3, respectively) were associated with independency (all p < 0.001). Higher frailty score was associated with longer time to complete the eRFA (all nonlinear association p < 0.001).
Frail patients are more likely to benefit from completion of GA to determine appropriate treatment. Given that not all cancer patients have a caregiver who can assist completing a digital questionnaire, innovative solutions are needed to help frail patients complete the eRFA without assistance.
本研究旨在评估患者虚弱程度与电子放射治疗计划评估（eRFA）的辅助需求和完成时间之间的关联程度，eRFA 是一种基于网络的 GA 工具。
我们回顾性地确定了 2015 年至 2020 年间因癌症接受手术且住院时间≥1 天并在手术前完成 eRFA 的患者。使用两种方法评估虚弱程度：MSK-FI（评分 0-11）和 AGD（评分 0-13）。eRFA 的完成时间由基于网络的工具自动记录；患者自行报告 eRFA 完成时是否需要协助。
共纳入 3456 例患者（中位年龄为 78 岁）。总体而言，58%的调查无需协助即可完成，30%的调查需要协助才能完成，12%的调查由患者以外的人完成。年龄较轻（中位年龄：无需协助者为 77 岁，需要协助者为 80 岁，由他人完成者为 80 岁）和虚弱评分较低（中位 AGD 分别为 4、6 和 8，中位 MSK-FI 分别为 2、3 和 3）与独立性相关（均 p<0.001）。较高的虚弱评分与完成 eRFA 的时间较长相关（所有非线性关联 p<0.001）。
虚弱的患者更有可能从完成 GA 以确定适当的治疗中受益。鉴于并非所有癌症患者都有可以协助完成数字问卷的照顾者，因此需要创新的解决方案来帮助虚弱的患者在无需协助的情况下完成 eRFA。
