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

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing Pub Date : 2025-03-14 DOI:10.1111/ajag.70012

Yunsong Li, Chunwei Peng, Bingbing Zou

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引用次数: 0

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.

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接受胃肠肿瘤根治性手术的老年人虚弱与术后并发症的关系

目的老年胃肠道恶性肿瘤患者虚弱与术后并发症相关。然而，虚弱与并发症严重程度之间的关系以及根治性手术后并发症的危险因素仍不清楚。方法采用改良后的衰弱指数（mFI）评分法评估患者的衰弱程度，比较虚弱组和非虚弱组患者的衰弱程度与术后并发症的相关性。采用Clavien-Dindo （C-D）系统评估并发症严重程度，采用多因素logistic分析，通过优势比（OR）确定术后并发症的独立危险因素。根据mFI将参与者分为非虚弱组和虚弱组。结果衰弱组60-69岁患者较少（19% vs. 31%, p = 0.03），中度CCI发生率较高（52% vs. 69%, p = 0.001）。虚弱与术后并发症密切相关，包括肺部感染（16%对8%，p = 0.009）、肺栓塞（8%对3%，p = 0.02）和急性肾损伤（14%对6%，p = 0.005）。老年体弱患者出现更严重的并发症，C-D III级（23%对10%，p = 0.004）和V级（6%对1%，p = 0.004）的发生率更高。多因素分析发现，虚弱（OR: 1.492, p = 0.02）、年龄大于70岁（OR: 1.239, p = 0.04）和严重合并症增加了严重并发症的OR。此外，体弱患者恢复较差，住院死亡率较高（4%对0%，p = 0.01），再入院率较高（11%对3%，p = 0.005），住院时间较长（9天对8天，p < 001），住院费用较高（48,035元对43,792元，p < 001）。结论老年体弱成人并发症更严重，术后恢复较差。

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来源期刊

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.