Frailty ups hospitalization cost, death risk in paediatric cancer patients

Frailty is associated with greater treatment cost and mortality among hospitalized children with cancer, suggests a US study, noting the need for further research on frailty-based risk stratification, as well as individualized intervention to improve patient outcomes.

“The adaptation and validation of a frailty-defining diagnostic tool in the paediatric population is a high priority in the field,” the authors said.

With the lack of studies on frailty among paediatric patients with cancer, the authors conducted this retrospective study to gain better understanding of the effects of frailty on hospital outcomes in children with cancer. Data on hospitalized patients were obtained from the Nationwide Inpatient Sample between 2005 and 2014.

Finally, the authors measured frailty using the frailty definition diagnostic indicator by Johns Hopkins Adjusted Clinical Groups.

A total of 187,835 paediatric cancer hospitalizations were included in the analysis. Of these, 11,497 (6.1 percent) were frail. The average hospitalization cost among frail patients was $86,910, while that among nonfrail patients was lower by more than half of that paid by frail counterparts at only $40,358.

In addition, propensity score matching analysis revealed a significantly higher likelihood of in-hospital mortality (odds ratio [OR], 2.08, 95 percent confidence interval [CI], 1.71‒2.52) and length of stay (OR, 3.76, 95 percent CI, 3.46‒4.08) for frail patients.

“The findings of our study suggest that frailty is a crucial clinical factor to be considered when treating paediatric cancer patients in a hospital setting,” the authors said.