Effect of preoperative frailty on postoperative infectious complications and prognosis in patients with colorectal cancer: a propensity score matching study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101170544 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7819 (Electronic) Linking ISSN: 14777819 NLM ISO Abbreviation: World J Surg Oncol Subsets: MEDLINE

Original Publication: London : BioMed Central, 2003-

Colorectal Neoplasms*/surgery ; Colorectal Neoplasms*/complications ; Colorectal Neoplasms*/pathology ; Colorectal Neoplasms*/mortality ; Propensity Score* ; Postoperative Complications*/epidemiology ; Postoperative Complications*/etiology ; Frailty*/complications ; Frailty*/epidemiology; Humans ; Male ; Female ; Prospective Studies ; Prognosis ; Aged ; Middle Aged ; Follow-Up Studies ; Length of Stay/statistics & numerical data ; Risk Factors ; Survival Rate ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Incidence

Background: Few studies have explored the impact of preoperative frailty on infectious complications in patients with a diagnosis of colorectal cancer (CRC). Therefore, this study aimed to investigate the effect of preoperative frailty on postoperative infectious complications and prognosis in patients with CRC using propensity score matching (PSM).
Methods: This prospective single-centre observational cohort study included 245 patients who underwent CRC surgery at the Department of Gastrointestinal Surgery, The Affiliated Lianyungang Hospital of Xuzhou Medical University between August 2021 to May 2023. Patients were categorised into two groups: frail and non-frail. They were matched for confounders and 1:1 closest matching was performed using PSM. Rates of infectious complications, intensive care unit (ICU) admission, 30-day mortality, and 90-day mortality, as well as postoperative length of hospital stay, total length of hospital stay, and hospital costs, were compared between the two groups. Binary logistic regression using data following PSM to explore independent factors for relevant outcome measures.
Results: After PSM, each confounding factor was evenly distributed between groups, and 75 pairs of patients were successfully matched. The incidence of intra-abdominal infectious complications was significantly higher in the frail group than in the non-frail group (10.7% vs. 1.3%, P < 0.05). There were no significant differences in ICU admission rate, postoperative length of hospital stay, total length of hospital stay, hospital costs, 30-day mortality rate, or 90-day mortality rate between the two groups (P > 0.05). Our logistic regression analysis result showed that preoperative frailty (OR = 12.014; 95% CI: 1.334-108.197; P = 0.027) was an independent factor for intra-abdominal infection.
Conclusions: The presence of preoperative frailty elevated the risk of postoperative intra-abdominal infectious complications in patients undergoing CRC surgery. Therefore, medical staff should assess preoperative frailty in patients with CRC early and provide targeted prehabilitation interventions.
(© 2024. The Author(s).)

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No. SJCX22_1293 the Postgraduate Research & Practice Innovation Program of Jiangsu

Keywords: Adverse outcomes; Colorectal cancer; Complications; Frailty; Intra-abdominal infection; Propensity score matching

Date Created: 20240611 Date Completed: 20240611 Latest Revision: 20240614

20240614

PMC11167934

10.1186/s12957-024-03437-y

38862958