Abstract Background Impact of frailty on prognosis in patients with metastatic and non-metastatic colorectal cancer (CRC) was studied. Methods Patients aged ≥60 years with CRC were identified in Nationwide Inpatient Sample database and analyzed retrospectively. Frailty was defined when Hospital Frailty Risk Score ≥5. Patients were grouped and matched by metastatic status. Logistic and linear regression were used to assess association between frailty and in-hospital outcomes. Results After matching, 99, 017 metastatic and 418, 435 non-metastatic CRC were included. Frailty was significantly associated with increased in-hospital mortality (metastatic: OR = 1. 10, 95% CI 1. 05–1. 17; non-metastatic: aOR = 1. 05, 95% CI 1. 00–1. 10), prolonged length of stay (metastatic: OR = 1. 30, 95% CI 1. 26–1. 34; non-metastatic: aOR = 1. 37, 95% CI 1. 34–1. 39), and discharge to long-term care (metastatic: OR = 1. 67, 95% CI 1. 62–1. 73; non-metastatic: aOR = 2. 10, 95% CI 2. 07–2. 14). Frailty was also associated with higher total hospital costs, with additional 3, 750 (95% CI 2940–4560) in metastatic CRC and 1920 (95% CI 1480–2360) in non-metastatic CRC. Conclusions Frailty is an independent predictor of adverse outcomes among older patients with CRC, regardless of metastatic status.
Cheng et al. (2026) studied this question.