Association between frailty and healthcare resource utilization in older adults with pancreatic cancer: A retrospective cohort study.

Abstract

e16404 Background: Frailty is a critical determinant of health outcomes in older adults and may influence the management and prognosis of pancreatic cancer. The Electronic Frailty Index (EFI), a multidimensional tool derived from electronic health records, provides a standardized method to quantify frailty. However, its role in predicting healthcare resource utilization (HCRU) in older adults with pancreatic cancer remains underexplored. This study examines the association between pretreatment EFI scores and HCRU, including unplanned hospitalizations and emergency department (ED) visits, in this population. Methods: This retrospective cohort study included adults aged ≥70 years diagnosed with pancreatic cancer between 2008 and 2022 at Moffitt Cancer Center. EFI scores were calculated using pre-diagnosis data, including comorbidities, functional status, and laboratory values. HCRU was defined as the total number of unplanned hospitalizations and ED visits. Multivariable regression models adjusted for age, sex, tumor stage, treatment modality, and baseline comorbidities were used to assess the relationship between EFI and HCRU outcomes. Subgroup analyses were performed by EFI categories: low, moderate, and high frailty. Results: Among 686 patients (median age: 75.5 years, range: 70–93; 45% female), 32.8% had advanced-stage pancreatic cancer, 80% underwent chemotherapy, and 89.4% had ≥3 comorbidities (CMs). EFI classification included 27.1% as low frailty, 58.5% as moderate frailty, and 14.3% as high frailty. A trend was observed between higher EFI scores and increased HCRU; however, these associations were not statistically significant. For unplanned hospitalizations, the odds ratio (OR) was 1.15 (95% CI: 0.85–1.55; P = 0.2834), and for ED visits, the OR was 1.12 (95% CI: 0.78–1.46; P = 0.2834). Subgroup analyses revealed a similar trend but lacked statistical significance. Conclusions: This study identified a potential trend between frailty and HCRU in older adults with pancreatic cancer, though findings were limited by sample size and statistical insignificance. Further research with larger cohorts is needed to confirm these trends and explore interventions to optimize healthcare utilization in this population.