The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer

Ajay T Bakas,1 Aniel Sewnaik,1 Jaclyn van Straaten,2 Robert J Baatenburg de Jong,1 Francesco US Mattace-Raso,2 Harmke A Polinder-Bos2 1Department of Otorhinolaryngology, Erasmus MC University Cancer Institute, Rotterdam, the Netherlands; 2Division of Geriatric Medicine, Department of Internal Medici...

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Autores principales: Bakas AT, Sewnaik A, van Straaten J, Baatenburg de Jong RJ, Mattace-Raso FUS, Polinder-Bos HA
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:24f8ff5bd7c1412f9d586ae7c37b14e22021-12-02T18:33:29ZThe Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer1178-1998https://doaj.org/article/24f8ff5bd7c1412f9d586ae7c37b14e22021-09-01T00:00:00Zhttps://www.dovepress.com/the-multidimensional-prognostic-index-as-a-measure-of-frailty-in-elder-peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Ajay T Bakas,1 Aniel Sewnaik,1 Jaclyn van Straaten,2 Robert J Baatenburg de Jong,1 Francesco US Mattace-Raso,2 Harmke A Polinder-Bos2 1Department of Otorhinolaryngology, Erasmus MC University Cancer Institute, Rotterdam, the Netherlands; 2Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the NetherlandsCorrespondence: Ajay T BakasDepartment of Otorhinolaryngology, Erasmus MC University Cancer, Institute, Rotterdam, the NetherlandsTel +31-10-7040704Email a.bakas@erasmusmc.nlPurpose: The multidimensional prognostic index (MPI) is a prognostic model derived from the comprehensive geriatric assessment (CGA) which can predict 1-year mortality risk in elderly individuals. We hypothesized that the MPI also reflects the degree of frailty and thus will correlate with established measures of frailty. Therefore, the aim of this study is to explore whether the MPI-score is a measure of frailty in older head and neck cancer patients and is associated with several physical functioning measurements.Patients and Methods: From November 2019 to July 2020, a prospective cohort study enrolled patients with head and neck cancer aged ≥ 70 years, and patients < 70 years with an abnormal G8 score. The MPI-score ranged from 0 to 1 and was categorized in MPI-stage 1 (≤ 0.33, non-frail); MPI-stage 2 (0.34– 0.66, mildly frail), and MPI-stage 3 (≥ 0.67, severe frail). Pearson’s correlation coefficient and multivariable linear regression were used to study the association between MPI-score and the physical functioning measurements handgrip strength, gait speed, and the timed up and go test (TUGT).Results: A total of 163 patients were included. One hundred four (63.8%) patients were categorized as non-frail according MPI-stage 1, and 59 (36.2%) patients as mildly or severe frail (n=55 MPI-stage 2; n=4 MPI-stage 3, respectively). A higher MPI-score was significantly associated with lower hand grip strength (B − 0.49 [95% CI − 0.71; − 0.28] p< 0.001), lower gait speed (B − 0.41 [95% CI − 0.55; − 0.25] p< 0.001), and a slower TUGT (B 0.53 [95% CI 0.66; 0.85] p< 0.001).Conclusion: Almost one-third of the included patients with head and neck cancer was mild or severe frail. A higher MPI-score, indicating higher degree of frailty, was associated with worse physical performance by lower handgrip strength, gait speed, and a slower TUGT. Thus, the MPI reflects the degree of frailty.Keywords: comprehensive geriatric assessment, sarcopenia, head and neck cancer, multidimensional prognostic index, elderlyBakas ATSewnaik Avan Straaten JBaatenburg de Jong RJMattace-Raso FUSPolinder-Bos HADove Medical Pressarticlecomprehensive geriatric assessmentsarcopeniahead and neck cancermultidimensional prognostic indexelderlyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 1679-1689 (2021)
institution DOAJ
collection DOAJ
language EN
topic comprehensive geriatric assessment
sarcopenia
head and neck cancer
multidimensional prognostic index
elderly
Geriatrics
RC952-954.6
spellingShingle comprehensive geriatric assessment
sarcopenia
head and neck cancer
multidimensional prognostic index
elderly
Geriatrics
RC952-954.6
Bakas AT
Sewnaik A
van Straaten J
Baatenburg de Jong RJ
Mattace-Raso FUS
Polinder-Bos HA
The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer
description Ajay T Bakas,1 Aniel Sewnaik,1 Jaclyn van Straaten,2 Robert J Baatenburg de Jong,1 Francesco US Mattace-Raso,2 Harmke A Polinder-Bos2 1Department of Otorhinolaryngology, Erasmus MC University Cancer Institute, Rotterdam, the Netherlands; 2Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the NetherlandsCorrespondence: Ajay T BakasDepartment of Otorhinolaryngology, Erasmus MC University Cancer, Institute, Rotterdam, the NetherlandsTel +31-10-7040704Email a.bakas@erasmusmc.nlPurpose: The multidimensional prognostic index (MPI) is a prognostic model derived from the comprehensive geriatric assessment (CGA) which can predict 1-year mortality risk in elderly individuals. We hypothesized that the MPI also reflects the degree of frailty and thus will correlate with established measures of frailty. Therefore, the aim of this study is to explore whether the MPI-score is a measure of frailty in older head and neck cancer patients and is associated with several physical functioning measurements.Patients and Methods: From November 2019 to July 2020, a prospective cohort study enrolled patients with head and neck cancer aged ≥ 70 years, and patients < 70 years with an abnormal G8 score. The MPI-score ranged from 0 to 1 and was categorized in MPI-stage 1 (≤ 0.33, non-frail); MPI-stage 2 (0.34– 0.66, mildly frail), and MPI-stage 3 (≥ 0.67, severe frail). Pearson’s correlation coefficient and multivariable linear regression were used to study the association between MPI-score and the physical functioning measurements handgrip strength, gait speed, and the timed up and go test (TUGT).Results: A total of 163 patients were included. One hundred four (63.8%) patients were categorized as non-frail according MPI-stage 1, and 59 (36.2%) patients as mildly or severe frail (n=55 MPI-stage 2; n=4 MPI-stage 3, respectively). A higher MPI-score was significantly associated with lower hand grip strength (B − 0.49 [95% CI − 0.71; − 0.28] p< 0.001), lower gait speed (B − 0.41 [95% CI − 0.55; − 0.25] p< 0.001), and a slower TUGT (B 0.53 [95% CI 0.66; 0.85] p< 0.001).Conclusion: Almost one-third of the included patients with head and neck cancer was mild or severe frail. A higher MPI-score, indicating higher degree of frailty, was associated with worse physical performance by lower handgrip strength, gait speed, and a slower TUGT. Thus, the MPI reflects the degree of frailty.Keywords: comprehensive geriatric assessment, sarcopenia, head and neck cancer, multidimensional prognostic index, elderly
format article
author Bakas AT
Sewnaik A
van Straaten J
Baatenburg de Jong RJ
Mattace-Raso FUS
Polinder-Bos HA
author_facet Bakas AT
Sewnaik A
van Straaten J
Baatenburg de Jong RJ
Mattace-Raso FUS
Polinder-Bos HA
author_sort Bakas AT
title The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer
title_short The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer
title_full The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer
title_fullStr The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer
title_full_unstemmed The Multidimensional Prognostic Index as a Measure of Frailty in Elderly Patients with Head and Neck Cancer
title_sort multidimensional prognostic index as a measure of frailty in elderly patients with head and neck cancer
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/24f8ff5bd7c1412f9d586ae7c37b14e2
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