Pilot prospective study of Frailty and Functionality in routine clinical assessment in allogeneic hematopoietic cell transplantation
A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty S...
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| Published in | Bone marrow transplantation (Basingstoke) Vol. 56; no. 1; pp. 60 - 69 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Nature Publishing Group UK
01.01.2021
Nature Publishing Group |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0268-3369 1476-5365 1476-5365 |
| DOI | 10.1038/s41409-020-0979-1 |
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| Abstract | A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5–6 min. Median age was 58 years (range: 19–77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92;
p
= 0.003), raised CRP (HR 4.40;
p
< 0.001), and hypoalbuminemia (HR 2.10;
p
= 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11;
p
= 0.009), TUGT > 10 s (HR 3.47;
p
= 0.003), GS (HR 2.56;
p
= 0.029), SRH (<excellent) (HR 3.8 × 10
6
;
p
< 0.001), elevated CRP (HR 11.8;
p
< 0.001), and hypoalbuminemia (HR 4.6;
p
< 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes. |
|---|---|
| AbstractList | A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5–6 min. Median age was 58 years (range: 19–77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92;
p
= 0.003), raised CRP (HR 4.40;
p
< 0.001), and hypoalbuminemia (HR 2.10;
p
= 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11;
p
= 0.009), TUGT > 10 s (HR 3.47;
p
= 0.003), GS (HR 2.56;
p
= 0.029), SRH (<excellent) (HR 3.8 × 10
6
;
p
< 0.001), elevated CRP (HR 11.8;
p
< 0.001), and hypoalbuminemia (HR 4.6;
p
< 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes. A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5-6 min. Median age was 58 years (range: 19-77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 106; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes.A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5-6 min. Median age was 58 years (range: 19-77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 106; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes. A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5-6 min. Median age was 58 years (range: 19-77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS [greater than or equal to] 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 10.sup.6; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes. A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5-6 min. Median age was 58 years (range: 19-77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 10 ; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes. A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5–6 min. Median age was 58 years (range: 19–77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 106; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worse non relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes. |
| Audience | Academic |
| Author | Law, Arjun Datt Lam, Wilson Pasic, Ivan Viswabandya, Auro Atenafu, Eshetu G. Salas, Maria Queralt Al-Shaibani, Zeyad Gerbitz, Armin Michelis, Fotios V. Kumar, Rajat Kim, Dennis (Dong Hwan) Lipton, Jeffrey Howard Wilson, Leeann Mattsson, Jonas Bascom, Ora Alibhai, Shabbir M. H. |
| Author_xml | – sequence: 1 givenname: Maria Queralt orcidid: 0000-0003-4567-3682 surname: Salas fullname: Salas, Maria Queralt organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Hematology Department, Institut Català d’Oncologia—Hospitalet, IDIBELL – sequence: 2 givenname: Eshetu G. orcidid: 0000-0002-4613-3680 surname: Atenafu fullname: Atenafu, Eshetu G. organization: Department of Biostatistics, Princes Margaret Cancer Centre, University Health Network – sequence: 3 givenname: Ora surname: Bascom fullname: Bascom, Ora organization: Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 4 givenname: Leeann surname: Wilson fullname: Wilson, Leeann organization: Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 5 givenname: Wilson surname: Lam fullname: Lam, Wilson organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 6 givenname: Arjun Datt orcidid: 0000-0002-9251-3609 surname: Law fullname: Law, Arjun Datt organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 7 givenname: Ivan surname: Pasic fullname: Pasic, Ivan organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 8 givenname: Dennis (Dong Hwan) orcidid: 0000-0003-2640-4911 surname: Kim fullname: Kim, Dennis (Dong Hwan) organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 9 givenname: Fotios V. surname: Michelis fullname: Michelis, Fotios V. organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 10 givenname: Zeyad surname: Al-Shaibani fullname: Al-Shaibani, Zeyad organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 11 givenname: Armin surname: Gerbitz fullname: Gerbitz, Armin organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 12 givenname: Auro surname: Viswabandya fullname: Viswabandya, Auro organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 13 givenname: Jeffrey Howard surname: Lipton fullname: Lipton, Jeffrey Howard organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 14 givenname: Jonas surname: Mattsson fullname: Mattsson, Jonas organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network – sequence: 15 givenname: Shabbir M. H. surname: Alibhai fullname: Alibhai, Shabbir M. H. organization: Department of Medicine, University Health Network – sequence: 16 givenname: Rajat orcidid: 0000-0002-4786-5699 surname: Kumar fullname: Kumar, Rajat email: rajat.kumar@uhn.ca organization: Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32606454$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:144078111$$DView record from Swedish Publication Index |
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| PublicationTitle | Bone marrow transplantation (Basingstoke) |
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| PublicationYear | 2021 |
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| Snippet | A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages... |
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| SubjectTerms | 692/499 692/700/784 Activities of daily living Albumins C-reactive protein Cell Biology Evaluation Frailty Grip strength Hematology Hematopoietic stem cells Internal Medicine Medicine Medicine & Public Health Public Health Questions Risk analysis Risk factors Stem cell transplantation Stem Cells Transplantation |
| Title | Pilot prospective study of Frailty and Functionality in routine clinical assessment in allogeneic hematopoietic cell transplantation |
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