An electronic frailty index can be used to predict survival and prolonged hospitalization in patients with colorectal cancer, according to a study presented at the 2022 ASCO Quality Care Symposium.

“It [the electronic frailty index] has the potential to be an automated, objective decision support tool,” said study presenter Huili Zhu, MD, of Baylor College of Medicine in Houston, Texas.

Dr Zhu and colleagues used data from 6043 patients in the Veterans Affairs Central Cancer Registry who were diagnosed with colorectal cancer during 2016-2020. 

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The electronic frailty index was calculated based on the Veterans Affairs-Frailty Index and using data from the electronic medical record. Patients were classified as robust (45.6%), prefrail (34.5%), or frail (19.9%) based on the results. 

Compared with robust patients, frail patients had a 90% increased risk of all-cause mortality (adjusted hazard ratio [aHR], 1.90; 95% CI, 1.71-2.11), and prefrail patients had a 21% increased risk (aHR, 1.21; 95% CI, 1.10-1.32).

Frail patients had a 79% increased risk for prolonged hospital stay (defined as a median length of 11 days or more), compared with robust patients (aOR, 1.79). Prefrail patients had a 38% increased risk of prolonged hospital stay (aOR, 1.38).  

All of these results were obtained after adjustment for age, gender, race, Charlson Comorbidity Index, cancer stage, and ECOG performance status, Dr Zhu noted. 

In the future, Dr Zhu and colleagues plan to develop a cancer-specific electronic frailty index with dynamic variables that change along the lifespan of a patient and to implement this new technology within the electronic medical record.


Zhu H, Razjouyan J, Yarlagadda S, Naik A, Sada YH. Electronic frailty index: A risk stratification tool for survival and health care outcomes in veterans with colorectal cancer. ASCO Quality Care Symposium 2022. Sept. 30 – Oct. 1, 2022. Abstract 375.