The Impact of Frailty on Patients Undergoing Liver Resection for Colorectal Liver Metastasis

J Gastrointest Surg. 2022 Mar;26(3):608-614. doi: 10.1007/s11605-021-05149-0. Epub 2021 Sep 20.

Abstract

Background: The aim of this study is to assess the impact of frailty on short-term outcomes after hepatectomy for colorectal liver metastasis (CRLM).

Methods: Patients were identified using the National Surgical Quality Improvement Program (NSQIP). Patients were divided into 3 categories using the 5-item Modified Frailty Index (mFI).

Results: There were 5230 patients included. 52%, 35%, and 13% had mFI scores of 0, 1, and ≥ 2 respectively. Patients with a ≥ 2 mFI score were more likely to experience minor complication (OR 1.34, 95% CI 1.06-1.69), major complication (OR 1.56, 95% CI 1.15-2.12), readmission (OR 1.55, 95% CI 1.12-2.14), unfavorable discharge (OR 2.48, 95% CI 1.62-3.80), 30-day mortality (OR 3.02, 95% CI 1.02-8.95), prolonged length of stay (OR 1.47, 95% CI 1.18-1.83), and bile leak (OR 1.51, 95% CI 1.02-2.24).

Conclusion: Frailty is associated with increased post-operative complications. The 5-item mFI can guide risk stratification, optimization, and counseling.

Keywords: Colorectal cancer; Frailty; Liver resection.

MeSH terms

  • Colorectal Neoplasms* / complications
  • Colorectal Neoplasms* / surgery
  • Frailty* / complications
  • Hepatectomy / adverse effects
  • Humans
  • Liver Neoplasms* / complications
  • Liver Neoplasms* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors