Screening for frailty among older patients with cancer using blood biomarkers of inflammation
Harneshaug, Magnus; Kirkhus, Lene; Saltyte Benth, Jurate; Grønberg, Bjørn Henning; Bergh, Sverre; Whist, Jon Elling; Rostoft, Siri; Jordhøy, Marit Slaaen
Peer reviewed, Journal article
Accepted version
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Date
2018Metadata
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- Institutt for klinisk og molekylær medisin [3426]
- Publikasjoner fra CRIStin - NTNU [37219]
- St. Olavs hospital [2441]
Abstract
As frailty is associated with inflammation, biomarkers of inflammation may represent objective measures that could facilitate the identification of frailty. Glasgow prognostic score (GPS), combines C-reactive protein (CRP) and albumin, and isscored from 0-2 points. Higher score indicates a higher degree of inflammation.Objectives: To investigate whether (1)GPS is associated with frailty,(2)GPS could be used to screen for frailty, (3) IL-6 and TNF-α add to the accuracy of GPS as a screening tool, and(4)GPS adds prognostic information in frail older cancer patients.Methods:Prospective, observational study of 255 patients ≥ 70 years with solid malignant tumours referred for medical cancer treatment.At baseline, frail patients were identified by a modified Geriatric Assessment (mGA), andblood samples were collected. Results: Mean age was 76.7years, 49.8% were frail, and 56.1% had distant metastases. The proportion of frail patients increased with higher GPS (GPSzero: 43.2%, GPSone:52.7%, GPStwo: 94.7%). GPStwowas significantly associated with frailty (OR 18.5), independent of cancer type, stage, BMI and the use of anti-inflammatory drugs. The specificity of GPS was high (99%), but the sensitivity waslow (14%). Frail patients with GPStwohad poorer survival than patients with GPS zero-one. TNF-α and IL-6 did not improve the accuracy of GPS when screening for frailty.Conclusion: Frailty and GPStwoarestrongly associated,and GPStwois a significant prognostic factor in frail, older cancer patients. The inflammatory biomarkers investigated are not suitable screening tools for frailty.