Hirohisa Okabe1, Takayuki Ohsaki2, Katsuhiro Ogawa3, Nobuyuki Ozaki4, Hiromitsu Hayashi5, Shinichi Akahoshi6, Yoshiaki Ikuta7, Kenichi Ogata8, Hideo Baba9, Hiroshi Takamori10. 1. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan; Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: okabeh@kumamoto-u.ac.jp. 2. Department of Rehabilitation, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: takayuki-osaki@saiseikaikumamoto.jp. 3. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: katsuhiro-ogawa@saiseikaikumamoto.jp. 4. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: zakky0727natuka@yahoo.co.jp. 5. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: h.hayashi13@gmail.com. 6. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: r-star1@hotmail.co.jp. 7. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: ikuta@lime.ocn.ne.jp. 8. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: k-ogata@da2.so-net.ne.jp. 9. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: hdobaba@kumamoto-u.ac.jp. 10. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: hiroshi-takamori@saiseikaikumamoto.jp.
Abstract
BACKGROUND: We aim to clarify if frailty affects severe postoperative complications in elective colorectal surgery. METHODS: Consecutive 269 colorectal cancer patients older than 65 years undergoing curative surgery were enrolled in this study. The relevance of the frailty and sarcopenia to postoperative outcome was assessed. Clinical frailty (CF) was defined as clinical frailty scale (CFS) ≥ 4. Sarcopenia was assessed by measuring skeletal muscle area using computed tomography. RESULTS: Seventy-eight patients (29%) had CF and 159 patients (59%) had sarcopenia. CF was significantly associated with older age (P = 0.0008), postoperative severe complications (P = 0.001), and postoperative in-hospital stay (P < 0.0001), although sarcopenia was not. Logistic regression analysis revealed that low anterior resection and CF were independent predictors of severe postoperative complications (P = 0.038 and P = 0.001, respectively). CONCLUSION: CF, but not sarcopenia, is a robust predictor of severe postoperative complications in patients with colorectal cancer.
BACKGROUND: We aim to clarify if frailty affects severe postoperative complications in elective colorectal surgery. METHODS: Consecutive 269 colorectal cancerpatients older than 65 years undergoing curative surgery were enrolled in this study. The relevance of the frailty and sarcopenia to postoperative outcome was assessed. Clinical frailty (CF) was defined as clinical frailty scale (CFS) ≥ 4. Sarcopenia was assessed by measuring skeletal muscle area using computed tomography. RESULTS: Seventy-eight patients (29%) had CF and 159 patients (59%) had sarcopenia. CF was significantly associated with older age (P = 0.0008), postoperative severe complications (P = 0.001), and postoperative in-hospital stay (P < 0.0001), although sarcopenia was not. Logistic regression analysis revealed that low anterior resection and CF were independent predictors of severe postoperative complications (P = 0.038 and P = 0.001, respectively). CONCLUSION: CF, but not sarcopenia, is a robust predictor of severe postoperative complications in patients with colorectal cancer.
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