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Australasian journal on ageing
Mar, 2025;44 (1): e70012.

Relationship of frailty and postoperative complications in older people who underwent radical surgery for a gastrointestinal tumour.

Yunsong Li, Chunwei Peng, Bingbing Zou
Author Information
  1. Yunsong Li: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. ORCID
  2. Chunwei Peng: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
  3. Bingbing Zou: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
PMID: 40084587 DOI: 10.1111/ajag.70012

Abstract

OBJECTIVE: Frailty is associated with postoperative complications in older people with gastrointestinal malignancies. However, the relationship between frailty and complication severity, as well as the risk factors for complications after radical surgery, is still unclear.
METHODS: Frailty was assessed using a modified Frailty Index (mFI) score, and the correlation between frailty and postoperative complications was compared between frail and non-frail groups. Complication severity was evaluated using the Clavien-Dindo (C-D) system, and independent risk factors for postoperative complications were identified through odds ratios (OR) using multivariate logistic analysis. The participants were divided into non-frailty and frailty groups based on the mFI.
RESULTS: The frailty group had fewer patients aged 60-69 years (19% vs. 31%, p = .03) and a higher incidence of moderate CCI (52% vs. 69%, p = .001). Frailty was strongly linked to postoperative complications, including pulmonary infections (16% vs. 8%, p = .009), pulmonary embolism (8% vs. 3%, p = .02) and acute kidney injury (14% vs. 6%, p = .005). Older frail patients experienced more severe complications, with higher rates of C-D grade III (23% vs. 10%, p = .004) and grade V (6% vs. 1%, p = .004). Multivariate analysis found that frailty (OR: 1.492, p = .02), age greater than 70 years (OR: 1.239, p = .04) and severe comorbidities increased the OR of severe complications. Additionally, frail patients had poorer recovery, with higher in-hospital mortality (4% vs. 0%, p = .01), more ICU readmissions (11% vs. 3%, p = .005), longer stays (9 vs. 8 days, p < .001) and higher costs (48,035 RMB vs. 43,792 RMB, p < .001).
CONCLUSIONS: Older frail adults experienced more severe complications and had worse postoperative recovery.

Keywords

aged frailty gastrointestinal neoplasms postoperative complications

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Grants

  1. GXXT-2022-056/University Synergy Innovation Program of Anhui Province
  2. 2023jyxml111/Key Project of the Department of Education Quality Engineering

MeSH Term

Humans
Aged
Postoperative Complications
Male
Female
Frailty
Risk Factors
Middle Aged
Frail Elderly
Gastrointestinal Neoplasms
Age Factors
Geriatric Assessment
Treatment Outcome
Aged, 80 and over
Multivariate Analysis
Retrospective Studies
Digestive System Surgical Procedures
Risk Assessment
Time Factors
Logistic Models
Odds Ratio
Chi-Square Distribution
Journal Article

Word Cloud

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