Correlation between physical status measures and frailty score in patients undergoing pancreatic resection

Background: This study aimed to assess the correlation between validated measures of physical status in a prehabilitation regimen with an established frailty score and analyze changes in these measures after completion of a directed prehabilitation program among patients undergoing elective pancreatic resection. Methods: Adult patients undergoing pancreatic resection from 2019-2021 were enrolled in a pilot prehabilitation program. Three validated measures of physical status were used: the 6-minute walk test, grip strength, and chair-stand test. The prehabilitation program comprised 7,500 steps, 30 grip strength exercises, and 100 chair-stand exercises daily. Patients' frailty score was calculated using the Modified Johns Hopkins Frailty score. Changes in physical status measures after prehabilitation and postoperative outcomes were compared. Results: Thirty-two patients with a median age of 69.0 years (interquartile range = 59.5-76.3 years) were included. Patients' median duration of participation was 21.5 days (interquartile range = 16-29 days). There was a negative correlation between increasing frailty score and baseline the 6-minute walk test (R-2 = 0.17) and chair-stand test (R-2 = 0.18). Patients' mean the 6-minute walk test decreased at the end of the prehabilitation program, while grip strength and chair-stand test were unchanged. When stratified by low or intermediate and high frailty scores, the differences in the 6-minute walk test and chair-stand test were unchanged. Hospital duration of stay, complications, and 90-day readmission rates were not different between frailty groups (P > .05). Conclusion: Correlation of physical status measures with frailty score suggests only one of these measures is sufficient to estimate patients' preoperative physical status. A longer, more comprehensive prehabilitation program or an expedited operation are likely the best strategies to improve patient outcomes. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to evaluate the correlation between validated measures of physical status in a prehabilitation program and an established frailty score, and to analyze the changes in these measures and postoperative outcomes. The results showed a negative correlation between the physical status measures and the frailty score. One of the physical measures decreased after the prehabilitation program, while the others remained unchanged. Differences in the measures were unchanged when stratified by frailty scores. There were no significant differences in hospital duration, complications, and 90-day readmission rates between frailty groups. The study concluded that using one of the physical measures is sufficient to estimate patients' preoperative physical status, and a longer or more comprehensive prehabilitation program or expedited operation may improve patient outcomes.