The predictive impact of frailty index after emergency colectomy for obstructing and perforated colon cancer

Abstract

This study aimed to analyze the predictive impact of frailty index and patterns of outcomes in patients with obstructing and perforated colon cancer who had emergency surgery. Patients that underwent right and left hemicolectomy within emergency conditions such as obstruction or perforation of tumor between February 2017 and October 2020 were retrospectively evaluated. The 5-mFI score was measured by multiplying each number of frailty features (1 point per each existence; 0 - 5 points)and categorized into three groups (mFI = 0, mFI = 1, and mFI ≥ 2). The average age of the patient population was 65.21±13.84 years old. The male patients were 60 (60%). The morbidity (16, 24.6% vs. 16, 47.1%), p=0.041) and mortality (10, 15.4% vs. 9, 26.5%, p=0.289) were more likely seen for right-sided tumors. Stoma formation was seen more likely for left-sided tumors (29, 60% vs. 8, 23.5%, p=0.001).Albumin level was seen lower in patients who had higher mFI (3.86±0.63vs. 3.51±0.76 vs. 3.51±0.65, p=0.045). The predictive outcomes regarding the mFI potentially showed increased CDC [OR: 1.49, 95%CI: 0.82-2.75, p=0.2], morbidity [OR: 2.43, 95%CI: 0.50-13.98, p=0.3], and leakage [OR: 2.02, 95%CI: 0.63-6.65, p=0.2]. The 5-mFI score emerges to be utilized as a preoperative prognostic tool for emergency colon surgery considering morbidity, mortality, prolonged hospitalization, and reoperation. This seems to be relevant regardless of right or left-sided colon cancer.