School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
Semin Oncol Nurs. 2024 Apr;40(2):151617. doi: 10.1016/j.soncn.2024.151617. Epub 2024 Feb 28.
To examine the diagnostic performance of the FRAIL Scale for frailty screening with reference to the Fried phenotype and investigate its association with health outcomes in older cancer survivors.
In this cross-sectional quantitative study, participants were post-treatment cancer survivors aged 65 or above. Measurements included the FRAIL Scale, Fried phenotype, Geriatric Depression Scale-15 item, Modified Barthel Inventory, and EORTC Core Quality of Life Questionnaire. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of the FRAIL Scale with reference to the Fried phenotype. Health outcomes associated with being frail as estimated by the FRAIL Scale and Fried phenotype were also examined using regressions.
Based on 293 older cancer survivors, the area under curve (AUC) of the FRAIL Scale was 0.79, and the optimal cut-off of 1 yielded a sensitivity of 92% and specificity of 41%. According to regression results, the FRAIL Scale was modified by adding an item on time since cancer treatment completion (AUC = 0.81), and using a cut-off of 2 for older cancer survivors, which yielded a sensitivity of 74% and specificity of 67%. The modified FRAIL Scale was associated with depressive symptoms, functional independence, fatigue, dyspnea, physical functioning, and role functioning.
The modified FRAIL Scale is proposed for use in older cancer survivors, and a cut-off of 2 should be used.
The modified FRAIL Scale can serve as a brief screening tool for identifying frailty among older cancer survivors in practice.
通过与 Fried 表型比较，考察 FRAIL 量表在虚弱筛查中的诊断性能，并研究其与老年癌症幸存者健康结局的关系。
在这项横断面定量研究中，参与者为年龄在 65 岁及以上的癌症治疗后幸存者。测量包括 FRAIL 量表、Fried 表型、老年抑郁量表 15 项、改良巴氏量表和 EORTC 核心生活质量问卷。进行了受试者工作特征曲线分析，以评估 FRAIL 量表与 Fried 表型参考的诊断性能。还使用回归分析了 FRAIL 量表和 Fried 表型估计的虚弱与健康结局的关系。
基于 293 名老年癌症幸存者，FRAIL 量表的曲线下面积（AUC）为 0.79，最佳截断值为 1 时，灵敏度为 92%，特异性为 41%。根据回归结果，FRAIL 量表通过增加一个关于癌症治疗完成后时间的项目进行了修改（AUC=0.81），并对老年癌症幸存者使用 2 的截断值，灵敏度为 74%，特异性为 67%。改良后的 FRAIL 量表与抑郁症状、功能独立性、疲劳、呼吸困难、身体功能和角色功能有关。
提出了改良的 FRAIL 量表用于老年癌症幸存者，并建议使用 2 的截断值。
改良后的 FRAIL 量表可作为一种简便的筛查工具，用于识别临床实践中老年癌症幸存者的虚弱。
