Comparison of preoperative and postoperative frailty in elderly following gastrointestinal cancer surgery

Year 2025, Volume: 11 Issue: 4, 753 - 761, 04.07.2025

Gorkem Ozdemir , Alper Sözütek

https://doi.org/10.18621/eurj.1622647

Abstract

Objectives: This study aimed to compare preoperative and postoperative frailty status in patients undergoing elective gastrointestinal cancer surgery using the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weigh) and Clinical Frailty Scale (CFS) indices and to determine the relationship between frailty and early postoperative complications as well as surgical outcomes.

Methods: This prospective study included patients aged 65 years and older who underwent elective gastrointestinal cancer surgery. Preoperative and early postoperative frailty assessments were conducted using the FRAIL and CFS scores. Statistical analyses were conducted to investigate the association between frailty scores and surgical/clinical outcomes.

Results: Of the 91 patients included in the studythe mean age was 70.9±6.1 years (range: 65-75). The mean FRAIL score increased postoperatively (1.9±1.2 preoperatively to 2.3±1.5 postoperatively, Δpost-pre: 0.4±0.9, P<0.001). A similar trend was observed in the CFS scale, the mean CFS score increased postoperatively (4.8±1.2 preoperatively to 5.1±1.6, postoperatively, Δpost-pre: 0.3±0.8, P<0.001). Patients with higher baseline frailty levels exhibited longer hospital stays (P=0.015), higher mortality rates (P=0.030), and increased rates of discharge with an ostomy or drain (P=0.003).

Conclusions: Our findings suggest that while frailty scores may increase postoperatively, higher baseline frailty score is associated with several adverse outcomes, including prolonged hospital stays, increased mortality, and a higher likelihood of requiring ostomies or drains upon discharge.

Keywords

Elderly patient , frailty , gastrointestinal cancer surgery , mortality , FRAIL , CFS scale

Ethical Statement

This observational prospective, cohort study was approved by the Adana City Training and Research Hospital Clinical Research Ethics Committee (Decision no. 3178, Date: 15.02.2024). Written informed consent was obtained from all participating patients.

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