Preoperative physiological reserve surrogate markers predict short-term adverse postoperative outcomes in cancer patients: a cross-sectional study

Abstract Purpose To mitigate surgery-related morbidity and mortality and elevate the standard of care for surgical patients, clinicians must leverage precise pre-operative risk assessment tools. This study aimed to investigate the predictive value of surrogate markers for preoperative physiological reserve in relation to postoperative outcomes. Methods We analyzed data from 125 patients undergoing elective surgery for gastric or head and neck cancer (December 2018 to June 2019), using binary logistic regression models, adjusted for confounders. Outcomes of interest were: postoperative complications, major complications, need for intermediate care unit, prolonged length of stay (> 10 days), 30-days readmission, 30-days reintervention and postoperative burden (patients who had ≥ 1 adverse postoperative outcome, among those mentioned above). Results Low physical activity (OR, 2.34; [95% CI, 1.03–5.35], p = 0.043) and frailty (OR, 5.73; [95% CI, 1.79–18.34], p = 0.003) increased the probability of intermediate care unit admission. Frailty predicted postoperative burden (OR, 4.58; [95% CI, 1.60-13.08], p = 0.004). Low gait speed raised the likelihood of reintervention within 30 days (OR, 5.22; [95% CI, 1.23–22.19], p = 0.025). Probable sarcopenia heightened the odds of prolonged hospitalization (OR, 3.18; [95% CI, 1.15–8.81], p = 0.026). Conclusion Low physical activity, low gait speed, probable sarcopenia and frailty are independent predictors of short-term adverse postoperative outcomes. The identified predictors emphasize the need for an integrated approach to patient care, incorporating prehabilitation strategies tailored to individual risk profiles.