Factors influencing frailty and nomogram model construction in patients with hematologic malignancy receiving chemotherapy

Qi Xiaohua; Gao Guangxun; Wang Fangfang; Hu Lei; Tian Dandan; He Haolan; Zhu Li

doi:10.11986/j.issn.1673-873X.2025.11.14

Abstract：Objective To investigate factors associated with frailty in hematologic malignancy patients undergoing chemother-apy and to construct a nomogram prediction model to provide a reference for clinical care.Methods From June 2023 to May 2025,202 hematologic malignancy patients receiving chemotherapy at the First Affiliated Hospital of Air Force Medical Uni-versity were enrolled.Data were collected by questionnaire;all scale assessments were completed within 24 hours before the start of the current chemotherapy cycle.Scales included a general information questionnaire,the Fried Frailty Phenotype(FP),the Self-Rating Anxiety Scale(SAS),the Self-Rating Depression Scale(SDS),the Barthel Index,and Nutritional Risk Screening 2002(NRS 2002).Multivariable logistic stepwise regression analysis was used to identify influencing factors related to frailty;receiver operating characteristic(ROC)curve analysis was adopted to evaluate the nomogram's predictive performance.Results Among the 202 patients,85 had FP ≥3 points,yielding a frailty prevalence of 42.08％.Univariate analysis showed that,compared with the non-frail group,the frail group had significantly higher proportions of patients aged ≥60 years,living alone,body mass index＜18.5 kg/m2,≥ 2 chronic comorbidities,≥2 prior chemotherapy cycles,anxiety,depression,impaired activities of daily living,and nutritional risk(P＜0.05).Multivariable stepwise logistic re-gression analysis identified age ≥60 years(OR=1.933,95％CI:1.391-2.687),chemotherapy cycles ≥ 2(OR=2.784,95％CI:1.788-4.336),impaired activities of daily living(OR=2.018,95％CI:1.435-2.838),depression(OR=2.255,95％CI:1.548-3.285),and presence of nutritional risk(OR=2.524,95％CI:1.679-3.795)as independent risk factors for frailty in patients with hematologic malignancy(P＜0.05).The nomogram's concordance index(C-index)was 0.815(95％CI:0.763-0.867);the calibration curve slope approached 1.The nomogram's area under the ROC curve(AUC)for predicting frailty was 0.907(95％CI:0.856-0.958),with a specificity of 68.53％and sensitivity of 92.67％.Conclusion Age,number of chemotherapy cycles,impaired activities of daily living,depression,and nutritional risk are as-sociated with frailty in hematologic malignancy patients receiving chemotherapy.The constructed nomogram based on these factors demonstrates good predictive accuracy.