• Madeleine Courtney-Brooks, A Rauda Tellawi, Jennifer Scalici, Linda R Duska, Amir A Jazaeri, Susan C Modesitt, and Leigh A Cantrell.
• Thornton Gynecology Oncology Service, Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, VA 22908, USA. mbc3fm@virginia.edu
• Gynecol. Oncol. 2012 Jul 1;126(1):20-4.

ObjectivesThe objective of this pilot study was to determine if frailty predicts surgical complications among elderly women undergoing gynecologic oncology procedures.MethodsA cohort of gynecologic oncology patients age ≥ 65, undergoing surgery between March and December 2011 was identified. Frailty was evaluated using a validated assessment tool. The primary outcome measure was 30 day postoperative complication rate.ResultsForty women were approached for study entry and 37 (92%) enrolled. The mean age was 73 years (range 65-95). The majority of women had a malignancy and underwent a major abdominal surgical procedure. Twenty-one women (57%) were not frail, 10 (27%) were intermediately frail and 6 (16%) were frail. There was no difference in age or prevalence of medical comorbidities between groups. Frail women had a significantly higher BMI compared to intermediately frail and not frail women, (36.0, 31.5 and 26.1 kg/m(2), p=0.02). The rate of 30-day surgical complications increased with frailty score and was 24%, versus 67% for women who were not frail as compared to the frail (p=0.04).ConclusionsPre-operative frailty assessment is well accepted by gynecologic oncology patients and feasible in a clinic setting. Frail women had a higher BMI, indicating that low body weight is not a marker for frailty, and had a significantly higher rate of 30-day postoperative complications in this pilot study. Initial findings support the concept of measuring frailty as a possible predictor for postoperative morbidity that will allow for improved patient counseling and decision making.Copyright © 2012 Elsevier Inc. All rights reserved.

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