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The Clinical Frailty Scale can indicate prognosis and care requirements on discharge in oncology and haemato-oncology inpatients: A cohort study.

Lookup NU author(s): Jenny Welford, Kathryn Hunt, Louise Duncan, Dr Ann Ward, Professor Adam ToddORCiD, Michael Clarke, Dr Anne Pelham, Dr Felicity Dewhurst, Professor Alastair GreystokeORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Objectives: Routinely used performance status scales, assessing patients' suitability for cancer treatment, have limited ability to account for multimorbidity, frailty and cognition. The Clinical Frailty Scale (CFS) is a suggested alternative, but research detailing its use in oncology is limited. This study aims to evaluate if CFS is associated with prognosis and care needs on discharge in oncology inpatients. Methods: We evaluated a large, single-centre cohort study in this research. CFS was recorded for adult inpatients at a Regional Cancer Centre. The associations between CFS, age, tumour type, discharge destination and care requirements and survival were evaluated. Results and Conclusions: A total of 676 patients were included in the study. Levels of frailty were high (Median CFS 6, 81.8% scored ≥5) and CFS correlated with performance status (R = 0.13: P = 0.047). Patients who were frail (CFS ≥ 5) were less likely to be discharged home (62.9%) compared with those who were not classed as frail (86.1%) (OR 3.6 [95%CI 2.1 to 6.3]: P < 0.001). Higher CFS was significantly associated with poorer prognosis in all ages. Solid organ malignancy (hazard ratio [HR] 2.60 [95%CI 2.05–3.32]) and CFS (HR 1.43 [95%CI 1.29–1.59]; P < 0.001) were independently associated with poorer survival. This study demonstrated that CFS may help predict prognosis in adult oncology inpatients of any age. This may aid informed shared decision-making in this setting. Future work should establish if routine CFS measurement can aid the appropriate prescription of systemic therapy and enable early conversations about discharge planning.

Publication metadata

Author(s): Welford J, Rafferty R, Hunt K, Short D, Duncan L, Ward A, Rushton C, Todd A, Nair S, Hoather T, Clarke M, Dawes L, Dawson F, Anderson V, Pelham A, Lowe H, Dewhurst F, Greystoke A

Publication type: Article

Publication status: Published

Journal: European Journal of Cancer Care

Year: 2022

Volume: 31

Issue: 6

Online publication date: 26/10/2022

Acceptance date: 09/10/2022

Date deposited: 18/10/2022

ISSN (print): 0961-5423

ISSN (electronic): 1365-2354

Publisher: John Wiley and Sons Inc


DOI: 10.1111/ecc.13752


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Funder referenceFunder name
NIHR Newcastle Biomedical Research Centre
Sir Bobby Robson Foundation
The Newcastle upon Tyne Hospitals NHS Foundation Trust cancer charity