2540 - Frailty among Geriatric Radiation Oncology Patients: Weight Trends, Referral Patterns to Multidisciplinary Supportive Services, and Hospitalizations - A Single Center Experience

Purpose/Objective(s):

Age is both a risk factor for cancer diagnosis and a meaningful prognostic indicator. However, chronological age alone does not fully reflect a patient’s health. In older adults, frailty, often marked by weight loss, can significantly increase the risk of morbidity and mortality. Here, we describe the retrospective experience of a single center regarding weight trends, referral patterns to dietitians, and emergency/inpatient services utilization among geriatric patients following initial consultation for patients seen in the radiation oncology department.

Materials/Methods:

We retrospectively reviewed all new patient visits to the radiation oncology department at a single center between July 1 and December 8, 2025 for patients =70 years old. Weight at baseline and last follow-up were extracted for all patients with at least 30 days of follow-up data available. Referral orders to dietitian placed during the initial consultation visit were also tracked. Changes in weight over this period were assessed with a one-tailed, paired t-test.

Results:

In total, 415 patients had at least 30 days of follow-up data available with median age 77 (IQR: 73-81) years. 219 patients had weight measurements available at baseline and at least 30 days later. Median follow-up was 91 days, median time between initial and most recent weight was 77 days. A total of 38 ED visits, 35 inpatient admissions and 5 deaths were recorded.

Patients who visited the ED or were admitted had a decrease in weight (mean difference -2.6 kg, p < 0.05). Patients who did not visit the ED or hospital had stable weight (mean difference -0.01 kg, p > 0.05). Patients who lost weight during follow-up were referred to a dietitian at the time of initial consultation at similar rates to those who did not lose weight, although this rate was overall low (4% of encounters). Patients with head and neck cancer were 10% (43/415) of the overall group but accounted for 85% (17/20) of referrals placed for dietitian during initial consultation, 13% (12/91) of patients who had a recorded weight loss during this period, and 23% (9/39) of unique patients who visited the ED and/or were admitted.

Conclusion:

Weight loss in elderly cancer patients may portend increased risk of poor outcomes, including hospitalization. Proactive referral to a dietitian at the time of initial consultation was not common among the reviewed encounters. Although limited by its retrospective design, this study supports prospective efforts to identify frailty earlier and engage multidisciplinary teams to help prevent hospitalizations.