Evaluation of the predictability of FI-LAB frailty scale's baselinevalue and change in clinical endpoints in hospitalized cancer patients

ABSTRACT Kaya M.B., Evaluation of the Predictability of FI-LAB Frailty Scale's Baseline Value and Change in Clinical Endpoints in Hospitalized Cancer Patients, Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, 2024. A significant portion of cancer patients are over the age of 65. In this age group, decline in organ and system functions that occur with aging, multimorbidity, socioeconomic and psychological problems are important factors for frailty. The aim of this study is to evaluate the effects of FI-LAB score on length of stay, need for intensive care, inhospital mortality, and post-discharge survival in hospitalized cancer patients. For this purpose, hospitalized patients aged 65 and over with a diagnosis of cancer who were admitted to the emergency service of our center between January 2018 and May 2022 were included in the study. Demographic, clinical and laboratory data of the patients were examined retrospectively. Based on the FI-LAB score, patients were categorized as robust (<0.2), pre-frail (0.2-0.35), and frail (>0.35). The effect of frailty on endpoints was investigated using statistical methods. The average age of the total 1188 patients included in the study [736 (62%) men and 452 (38%) women] was 72.9±6.8 years. At first admission, 56 (4.7%) patients were considered robust, 286 (24.1%) patients were considered pre-frail, and 846 (71.2%) patients were considered frail, according to FI-LAB categories. The median hospital stay was 12 (4-159) days, 547 (46%) patients required intensive care, and 379 (31.9%) patients died in the hospital. Post-discharge 3, 6, and 12 month overall survival rates were 71.7±1.6%, 58.1±1.7% and 40.9±1.7%, respectively. Multivariate analysis showed that frailty according to FILAB score at first admission was associated with intensive care admission (OR: 4.401, 95%CI: 3.177-6.098, p<0.001), hospital mortality (OR: 5.032, 95%CI: 3.391-7.468, p<0.001). and post-discharge mortality (HR: 1.504, 95%CI: 1.258-1.799, p<0.001). Additionally, frailty according to the FI-LAB score at discharge was shown to be an independent predictor of overall survival after discharge (HR: 1.874, 95%CI: 1.582- 2.219, p<0.001). In conclusion, frailty is quite common in cancer patients and poses an independent risk for morbidity and mortality. FI-LAB score, including vital signs and laboratory results, has diagnostic and prognostic predictive properties in terms of clinical endpoints in these patients. Key words: Cancer, frailty, FI-LAB.