B117: How Frail is the Oncology Inpatient Population?

Rachel Nirsimloo1,Naomi Moodley1,Melanie Mackean1,Elizabeth MacDonald2

1Edinburgh Cancer Centre, Edinburgh, UK,2Western General Hospital, Edinburgh, UK

Presenting date: Tuesday 3 November
Presenting time: 12.20-13.10

Background

With advancements in therapy reflecting in increased overall survival the
demographics of cancer patients is changing. It is important that inpatient service
provision reflects this. The aim of this audit was to assess how many oncology inpatients meet (pre determined) frailty criteria and have more complex needs, impacting on length of inpatient stay, cost, and workload. 

Method

We conducted a "snapshot" audit using a modified version of the Balducci Fraility Criteria over a 24hr period. We adjusted the age limit to include ?65 years as criteria rather than ?85 years, since this is the lower age limit screened by the geriatric liaison team in our hospital. In addition to age, the other Balducci criteria are: 3 ? co-morbidities, ?1 geriatric syndrome and a dependency of any activity of daily living (ADL). The 24 hour period was allocated at random and a questionnaire completed as part of the ward round.

Results

70 surveys were completed across 5 oncology wards. The mean age was 63.9 years with a median age of 67 years i.e. the data is skewed by a few young patients but the majority were over 65 years (63%). 13% had ? 3co-morbidities, 51% had ? 1 geriatric syndrome and 47% were dependent in at least one ADL. Overall 80% met at least one criteria for frailty, 53% at least 2 criteria, 34% at least 3 criteria and 10% met all 4 criteria.

Conclusion

Our results confirm that oncology inpatients appear to be a frail population with complex needs. This was a snapshot audit over 24 hours only and further information gathered over a longer period would be useful. We have since established a new multi-disciplinary meeting to acknowledge these needs and consider how to improve patient management. We will re-audit to expand our data collection and assess the impact of the new MDT.