Frailty Is an Independent Marker of Post-Operative Mortality Following Colorectal Cancer Resection Surgery in Older Adults.

Objective: Frailty is a prognostic factor of post-operative death and complications following colorectal cancer surgery. Frailty assessment is not routinely performed, hence, the prevalence is unknown. The aim of this study was to establish the presence of frailty in patients aged ≥ 70 years, and to analyse differences in post-operative outcome comparing frail and non-frail elderly patients.

Methods: Data of patients aged ≥ 70 years who underwent colorectal cancer surgery during 2016-2020 were retrospectively obtained from the Swedish Colorectal Cancer Registry. A cohort of 500 patients was assessed for frailty using the Clinical Frailty Scale (CFS-9). Post-operative mortality rates, complications, readmissions, and length of stay (LOS) were compared between frail and non-frail patients.

Results: The prevalence of frailty (CFS-9 score ≥ 4) was 56%. The 90-day mortality rate was higher in frail patients (OR 4.97 [95% CI 1.06-23.28], p 0.042), as well as 1-year mortality (OR 4.39 [95% CI 1.86-10.34], p 0.0007). Frail patients had longer post-operative LOS (7.63 vs. 11.0 days, p < 0.001), were more often treated in ICU and more often discharged to a nursing home.

Conclusions: Frailty is a common condition in patients ≥ 70 years and a significant risk factor of post-operative mortality and morbidity.