The association between hospital frailty risk score and adverse inpatient outcomes in older adults with colorectal cancer

BACKGROUND: Impact of frailty on prognosis in patients with metastatic and non-metastatic colorectal cancer (CRC) was studied. METHODS: Patients aged ≥60 years with CRC were identified in Nationwide Inpatient Sample database and analyzed retrospectively. Frailty was defined when Hospital Frailty Risk Score ≥5. Patients were grouped and matched by metastatic status. Logistic and linear regression were used to assess association between frailty and in-hospital outcomes. RESULTS: After matching, 99,017 metastatic and 418,435 non-metastatic CRC were included. Frailty was significantly associated with increased in-hospital mortality (metastatic: OR = 1.10, 95% CI 1.05-1.17; non-metastatic: aOR = 1.05, 95% CI 1.00-1.10), prolonged length of stay (metastatic: OR = 1.30, 95% CI 1.26-1.34; non-metastatic: aOR = 1.37, 95% CI 1.34-1.39), and discharge to long-term care (metastatic: OR = 1.67, 95% CI 1.62-1.73; non-metastatic: aOR = 2.10, 95% CI 2.07-2.14). Frailty was also associated with higher total hospital costs, with additional $3,750 (95% CI $2940-$4560) in metastatic CRC and $1920 (95% CI $1480-$2360) in non-metastatic CRC. CONCLUSIONS: Frailty is an independent predictor of adverse outcomes among older patients with CRC, regardless of metastatic status.