Analysis on the occurrence and influencing factors of frailty in hospitalized patients with lung cancer
Objective To investigate the occurrence of frailty and its influencing factors in patients with lung cancer.Methods Patients with lung cancer receiving treatment at Xiangya Hospital of Central South University were recruited between March 2022 and March 2023.The FRAIL scale was employed to categorize the patients into non-frailty,pre-frailty,and frailty groups.A comparison of their basic data,disease data,and relevant laboratory indicators before treatment was conducted to identify factors influencing frailty in lung cancer patients.Results A total of 240 patients with lung cancer were analyzed in this study,comprising 46 patients(19.2%)in the non-frailty group,121 patients(50.4%)in the pre-frailty group,and 73 patients(30.4%)in the frailty group.The average age of the frailty and pre-frailty groups was significantly higher than that of the non-frailty group(P<0.05).Additionally,the body mass index(BMI)of the frailty group was significantly lower compared to both the non-frailty and pre-frailty groups(P=0.005).The proportion of male patients in the frailty group was lower than that of female patients,while the proportion of pre-frailty patients was higher among females(P=0.017).Furthermore,the percentage of patients receiving family care was lower in both the frailty and pre-frailty groups compared to those without family care(P<0.001).Various blood markers such as white blood cells(WBC),neutrophils(NEUT),N terminal pro B type natriuretic peptide(NT-proBNP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),neurophil to lymphocyte ratio(NLR),monocyte-lymphocyte ratio(MLR),and systemic inflammatory index(SII)were significantly elevated in the frailty group compared to the non-frailty group,whereas red blood cells(RBC),hemoglobin(Hb),hematocrit(HCT),lymphocytes(LYMPH),total protein(TP),albumin(Alb),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-desity lipoprotein cholesterol(LDL-C)were notably lower in the frailty group(all P<0.05).Similarly,NEUT,NLR,platelet to lymphocyte ratio(PLR),MLR,and SII were higher in the frailty group compared to the pre-frailty group,while RBC,Hb,HCT,LYMPH,TP,Alb,TC,HDL-C,and LDL-C were lower in the frailty group than the pre-frailty group(P<0.05).Moreover,NT-proBNP levels were higher in the pre-frailty group than in the non-frailty group,with all these differences being statistically significant(all P<0.05).The results of multifactorial Logistic regression analyses revealed several significant associations with frailty in lung cancer patients.Males had an increased risk of frailty(OR=2.80,P=0.033),while family care was linked to a decreased risk(OR=0.37,P=0.004).Additionally,advancing age was associated with a higher risk of frailty(OR=1.06,P=0.004).Furthermore,higher Alb levels were correlated with a reduced risk of frailty(OR=0.91,P=0.023),elevated LDL-C levels were associated with a lower risk(OR=0.59,P=0.027),and increased CEA levels were linked to a higher risk of frailty(OR=1.01,P=0.003)in lung cancer patients.Conclusions In lung cancer patients,older age,male gender,and higher CEA levels were linked to a higher risk of frailty,whereas family care,higher Alb levels,and high LDL-C levels were associated with a lower risk of frailty.These findings imply the importance of intensifying frailty screening in lung cancer patients to identify and intervene in frailty risk early on.