Association Between Preoperative Frailty And Postoperative Complications In Elderly Patients Undergoing Radical Surgery Of Gastrointestinal Tumor

Objectives:This study intends to retrospectively analyze the preoperative frailty status of elderly patients undergoing radical gastrointestinal tumor,and to clarify the relationship between frailty and postoperative complications.At the same time,the risk factors of postoperative complications were screened,and the predictive value of preoperative frailty on postoperative complications was discussed to provide reference for clinical practice.Methods: From September 2018 to January 2021,567 patients,underwent radical gastrointestinal tumor resection under general anesthesia.416 males and 151 females aged ≥ 65 years,ASA physical status Ⅰ to Ⅴ were selected.Perioperative data including clinical data and related clinical indicators were collected.Preoperative frailty status of patients was assessed by the modified Frailty Index（m FI）,then patients were divided into two groups: frailty group（m FI ≥0.27）and nonfrailty group（m FI<0.27）,and the perioperative data of the two groups were compared.Complications within 30 days after surgery were assessed using the Clavien-Dindo complication system and patients were divided into three groups: non-complication group,minor complication group,and major complication group.The general data and perioperative clinical data of the three groups were compared,and logistic regression analysis were used to analyze the influencing factors of different degrees of postoperative complications.Result: There were 567 patients in the whole group,including 504 non-frail patients and 63 frail patients.There were significant differences between the frail group and the non-frail group in age,proportion of ASA physical status III or V,preoperative serum albumin level,BMI,postoperative hospital stay,incidence of major complications and mortality within 30 days after surgery（P<0.05）.Logistic regression analysis showed that preoperative frailty was an independent risk factor for postoperative major complication（OR=3.545,95% CI 1.294～9.711,P=0.014）.Conclusion: Preoperative frailty before radical resection of gastrointestinal neoplasms in elderly patients was associated with a higher postoperative hospital stay,the incidence of serious complications and mortality within 30 days after surgery.Preoperative frailty was an independent risk factor for major complication within 30 days after radical surgery of gastrointestinal tumors in elderly patients.