Trends in frailty in brain tumor care during the COVID-19 pandemic in a nationwide hospital network in Germany

To compare frailty among brain tumor patients in Germany during the COVID-19 pandemic to the pre-pandemic era and to assess potential effects on brain tumor care. Using the Hospital Frailty Risk Index, we found that the overall frailty decreased significantly during the COVID-19 pandemic, compared to pre-pandemic levels. The simultaneous decrease in the Elixhauser Comorbidity Index was significantly more pronounced among high compared to low frailty cases. Among patients hospitalized for brain tumors in Germany, levels of frailty and the burden of comorbidities decreased during the COVID-19 pandemic. Among brain tumor patients, frailty is associated with poor outcomes. The COVID-19 pandemic has led to increased frailty in the general population. To date, evidence on changes in frailty among brain tumor patients during the pandemic is lacking. We aimed to compare frailty among brain tumor patients in Germany during the COVID-19 pandemic to the pre-pandemic era and to assess potential effects on brain tumor care. In this retrospective observational study, we compared frailty among brain tumor patients hospitalized during the COVID-19 pandemic in years 2020 through 2022 to pre-pandemic years 2016 through 2019 based on administrative data from a nationwide network of 78 hospitals in Germany. Using the Hospital Frailty Risk Score (HFRS), frailty was categorized as low, intermediate, or high. We examined changes in frailty, patient demographics, the burden of comorbidity, rates of surgery, and mortality rates for different frailty groups during the pandemic and compared them to pre-pandemic levels. Of the 20,005 included hospitalizations for brain tumors, 7979 were during the pandemic (mean age 60.0 years (± 18.4); females: 49.8