Association of frailty with long-term homecare utilization in older adults following cancer surgery: Retrospective population-based cohort study
Frailty is an important prognostic factor, and the association with postoperative dependence is important outcome to older adults. We examined the association of frailty with long-term homecare utilization for older adults following cancer surgery. In this population-based cohort study, we determine...
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| Veröffentlicht in: | European journal of surgical oncology 2021-04, Vol.47 (4), p.888-895 |
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| container_title | European journal of surgical oncology |
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| creator | Chesney, Tyler R. Haas, Barbara Coburn, Natalie Mahar, Alyson L. Davis, Laura E. Zuk, Victoria Zhao, Haoyu Wright, Frances Hsu, Amy T. Hallet, Julie |
| description | Frailty is an important prognostic factor, and the association with postoperative dependence is important outcome to older adults. We examined the association of frailty with long-term homecare utilization for older adults following cancer surgery.
In this population-based cohort study, we determined frailty status in all older adults (≥70 years old) undergoing cancer resection (2007–2017). Outcomes were receipt of homecare and intensity of homecare (days per month) over 5 years. We estimated the adjusted association of frailty with outcomes, and assessed interaction with age.
Of 82,037 patients, 6443 (7.8%) had frailty. Receipt and intensity of homecare was greater with frailty, but followed similar trajectories over 5 years between groups. Homecare receipt peaked in the first postoperative month (51.4% frailty, 43.1% no frailty), and plateaued by 1 year until 5 years (28.5% frailty, 12.8% no frailty). After 1 year, those with frailty required 4 more homecare days per month than without frailty (14 vs 10 days/month). After adjustment, frailty was associated with increased homecare receipt (hazard ratio 1.40; 95%CI 1.35–1.45), and increasing intensity each year (year 1 incidence rate ratio [IRR] 1.22, 95%CI 1.18–1.27 to year 5 IRR 1.47, 95%CI 1.35–1.59). The magnitude of the association of frailty with homecare receipt decreased with age (pinteraction |
| doi_str_mv | 10.1016/j.ejso.2020.09.009 |
| format | Article |
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In this population-based cohort study, we determined frailty status in all older adults (≥70 years old) undergoing cancer resection (2007–2017). Outcomes were receipt of homecare and intensity of homecare (days per month) over 5 years. We estimated the adjusted association of frailty with outcomes, and assessed interaction with age.
Of 82,037 patients, 6443 (7.8%) had frailty. Receipt and intensity of homecare was greater with frailty, but followed similar trajectories over 5 years between groups. Homecare receipt peaked in the first postoperative month (51.4% frailty, 43.1% no frailty), and plateaued by 1 year until 5 years (28.5% frailty, 12.8% no frailty). After 1 year, those with frailty required 4 more homecare days per month than without frailty (14 vs 10 days/month). After adjustment, frailty was associated with increased homecare receipt (hazard ratio 1.40; 95%CI 1.35–1.45), and increasing intensity each year (year 1 incidence rate ratio [IRR] 1.22, 95%CI 1.18–1.27 to year 5 IRR 1.47, 95%CI 1.35–1.59). The magnitude of the association of frailty with homecare receipt decreased with age (pinteraction <0.001).
While the trajectory of homecare receipt and intensity is similar between those with and without frailty, frailty is associated with increased receipt of homecare and increased intensity of homecare after cancer surgery across all age groups.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2020.09.009</identifier><identifier>PMID: 32980211</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Dependency ; Frailty ; Geriatric oncology ; Geriatric surgery ; Homecare ; Older adults ; Postoperative recovery</subject><ispartof>European journal of surgical oncology, 2021-04, Vol.47 (4), p.888-895</ispartof><rights>2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-a43c6ab96acb2f449f7314be42bfd87a542342b9900cec40cd8b289789342b923</citedby><cites>FETCH-LOGICAL-c356t-a43c6ab96acb2f449f7314be42bfd87a542342b9900cec40cd8b289789342b923</cites><orcidid>0000-0003-1904-4997 ; 0000-0002-2747-4121 ; 0000-0002-2295-6869</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejso.2020.09.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32980211$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chesney, Tyler R.</creatorcontrib><creatorcontrib>Haas, Barbara</creatorcontrib><creatorcontrib>Coburn, Natalie</creatorcontrib><creatorcontrib>Mahar, Alyson L.</creatorcontrib><creatorcontrib>Davis, Laura E.</creatorcontrib><creatorcontrib>Zuk, Victoria</creatorcontrib><creatorcontrib>Zhao, Haoyu</creatorcontrib><creatorcontrib>Wright, Frances</creatorcontrib><creatorcontrib>Hsu, Amy T.</creatorcontrib><creatorcontrib>Hallet, Julie</creatorcontrib><title>Association of frailty with long-term homecare utilization in older adults following cancer surgery: Retrospective population-based cohort study</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Frailty is an important prognostic factor, and the association with postoperative dependence is important outcome to older adults. We examined the association of frailty with long-term homecare utilization for older adults following cancer surgery.
In this population-based cohort study, we determined frailty status in all older adults (≥70 years old) undergoing cancer resection (2007–2017). Outcomes were receipt of homecare and intensity of homecare (days per month) over 5 years. We estimated the adjusted association of frailty with outcomes, and assessed interaction with age.
Of 82,037 patients, 6443 (7.8%) had frailty. Receipt and intensity of homecare was greater with frailty, but followed similar trajectories over 5 years between groups. Homecare receipt peaked in the first postoperative month (51.4% frailty, 43.1% no frailty), and plateaued by 1 year until 5 years (28.5% frailty, 12.8% no frailty). After 1 year, those with frailty required 4 more homecare days per month than without frailty (14 vs 10 days/month). After adjustment, frailty was associated with increased homecare receipt (hazard ratio 1.40; 95%CI 1.35–1.45), and increasing intensity each year (year 1 incidence rate ratio [IRR] 1.22, 95%CI 1.18–1.27 to year 5 IRR 1.47, 95%CI 1.35–1.59). The magnitude of the association of frailty with homecare receipt decreased with age (pinteraction <0.001).
While the trajectory of homecare receipt and intensity is similar between those with and without frailty, frailty is associated with increased receipt of homecare and increased intensity of homecare after cancer surgery across all age groups.</description><subject>Dependency</subject><subject>Frailty</subject><subject>Geriatric oncology</subject><subject>Geriatric surgery</subject><subject>Homecare</subject><subject>Older adults</subject><subject>Postoperative recovery</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAUhS0EotOBF2CBvGST4L9JbMSmqqAgVUJC7dpynJsZj5w42E6r6VP0kfF0Csuu7tXVd450z0HoAyU1JbT5vK9hn0LNCCM1UTUh6hVa0Q1nFaOb9jVakVbIqlWSn6HzlPakELxVb9EZZ0oSRukKPV6kFKwz2YUJhwEP0TifD_je5R32YdpWGeKId2EEayLgJTvvHk64KwrfQ8SmX3xOeAjeh3s3bbE1ky33tMQtxMMX_BtyDGkGm90d4DnMi3-yqDqToMc27ELMOOWlP7xDbwbjE7x_nmt0-_3bzeWP6vrX1c_Li-vK8k2TKyO4bUynGmM7NgihhpZT0YFg3dDL1mwE42VXihALVhDby45J1Ur1dGZ8jT6dfOcY_iyQsh5dsuC9mSAsSTMhGiUlFbKg7ITa8kSKMOg5utHEg6ZEH5vQe31sQh-b0ETpY85r9PHZf-lG6P9L_kVfgK8nAMqXdw6iTtZBya13sQSl--Be8v8L3G6eQg</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Chesney, Tyler R.</creator><creator>Haas, Barbara</creator><creator>Coburn, Natalie</creator><creator>Mahar, Alyson L.</creator><creator>Davis, Laura E.</creator><creator>Zuk, Victoria</creator><creator>Zhao, Haoyu</creator><creator>Wright, Frances</creator><creator>Hsu, Amy T.</creator><creator>Hallet, Julie</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1904-4997</orcidid><orcidid>https://orcid.org/0000-0002-2747-4121</orcidid><orcidid>https://orcid.org/0000-0002-2295-6869</orcidid></search><sort><creationdate>202104</creationdate><title>Association of frailty with long-term homecare utilization in older adults following cancer surgery: Retrospective population-based cohort study</title><author>Chesney, Tyler R. ; Haas, Barbara ; Coburn, Natalie ; Mahar, Alyson L. ; Davis, Laura E. ; Zuk, Victoria ; Zhao, Haoyu ; Wright, Frances ; Hsu, Amy T. ; Hallet, Julie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-a43c6ab96acb2f449f7314be42bfd87a542342b9900cec40cd8b289789342b923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Dependency</topic><topic>Frailty</topic><topic>Geriatric oncology</topic><topic>Geriatric surgery</topic><topic>Homecare</topic><topic>Older adults</topic><topic>Postoperative recovery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chesney, Tyler R.</creatorcontrib><creatorcontrib>Haas, Barbara</creatorcontrib><creatorcontrib>Coburn, Natalie</creatorcontrib><creatorcontrib>Mahar, Alyson L.</creatorcontrib><creatorcontrib>Davis, Laura E.</creatorcontrib><creatorcontrib>Zuk, Victoria</creatorcontrib><creatorcontrib>Zhao, Haoyu</creatorcontrib><creatorcontrib>Wright, Frances</creatorcontrib><creatorcontrib>Hsu, Amy T.</creatorcontrib><creatorcontrib>Hallet, Julie</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chesney, Tyler R.</au><au>Haas, Barbara</au><au>Coburn, Natalie</au><au>Mahar, Alyson L.</au><au>Davis, Laura E.</au><au>Zuk, Victoria</au><au>Zhao, Haoyu</au><au>Wright, Frances</au><au>Hsu, Amy T.</au><au>Hallet, Julie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of frailty with long-term homecare utilization in older adults following cancer surgery: Retrospective population-based cohort study</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2021-04</date><risdate>2021</risdate><volume>47</volume><issue>4</issue><spage>888</spage><epage>895</epage><pages>888-895</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Frailty is an important prognostic factor, and the association with postoperative dependence is important outcome to older adults. We examined the association of frailty with long-term homecare utilization for older adults following cancer surgery.
In this population-based cohort study, we determined frailty status in all older adults (≥70 years old) undergoing cancer resection (2007–2017). Outcomes were receipt of homecare and intensity of homecare (days per month) over 5 years. We estimated the adjusted association of frailty with outcomes, and assessed interaction with age.
Of 82,037 patients, 6443 (7.8%) had frailty. Receipt and intensity of homecare was greater with frailty, but followed similar trajectories over 5 years between groups. Homecare receipt peaked in the first postoperative month (51.4% frailty, 43.1% no frailty), and plateaued by 1 year until 5 years (28.5% frailty, 12.8% no frailty). After 1 year, those with frailty required 4 more homecare days per month than without frailty (14 vs 10 days/month). After adjustment, frailty was associated with increased homecare receipt (hazard ratio 1.40; 95%CI 1.35–1.45), and increasing intensity each year (year 1 incidence rate ratio [IRR] 1.22, 95%CI 1.18–1.27 to year 5 IRR 1.47, 95%CI 1.35–1.59). The magnitude of the association of frailty with homecare receipt decreased with age (pinteraction <0.001).
While the trajectory of homecare receipt and intensity is similar between those with and without frailty, frailty is associated with increased receipt of homecare and increased intensity of homecare after cancer surgery across all age groups.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32980211</pmid><doi>10.1016/j.ejso.2020.09.009</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1904-4997</orcidid><orcidid>https://orcid.org/0000-0002-2747-4121</orcidid><orcidid>https://orcid.org/0000-0002-2295-6869</orcidid></addata></record> |
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| subjects | Dependency Frailty Geriatric oncology Geriatric surgery Homecare Older adults Postoperative recovery |
| title | Association of frailty with long-term homecare utilization in older adults following cancer surgery: Retrospective population-based cohort study |
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