Why the study?
While the 11-factor Modified Frailty Index predicts adverse outcomes after radical resection of colorectal cancer, research on the applicability of the 5-factor Modified Frailty Index (mFI-5) in this population was lacking.
Does an mFI-5 score ≥ 2 predict severe postoperative complications and adverse outcomes in elderly patients undergoing radical resection for colorectal cancer?
Does an mFI-5 score ≥ 2 predict severe postoperative complications and adverse outcomes in elderly patients undergoing radical resection for colorectal cancer?
The mFI-5 is a practical clinical assessment tool that effectively predicts serious complications and prolonged hospital stays in elderly patients undergoing radical resection for colorectal cancer.
Answers are grounded in this paper and cite their sources.
May support mFI-5 frailty screening before elderly colorectal cancer resection; hypothesis-generating pending prospective validation.
BACKGROUND: Frailty is considered a characteristic manifestation of physiological decline in multiple organ systems, which significantly increases the vulnerability of elderly individuals with colorectal cancer (CRC) and is associated with a poor prognosis. While studies have demonstrated that the 11-factor Modified Frailty Index (mFI-11) can effectively predict adverse outcomes following radical resection of CRC, there is a lack of research on the applicability of the 5-factor Modified Frailty Index (mFI-5) within this patient population. METHODS: In this retrospective analysis, we examined a cohort of CRC patients aged 65 years and above who had undergone radical resection. For each patient, we calculated their mFI-5 score, considering a score of ≥ 2 as an indication of frailty. We conducted univariate and multivariate analyses to assess the association between the mFI-5 and adverse outcomes as well as postoperative complications. RESULTS: Patients with an mFI-5 score ≥ 2 exhibited a significantly higher incidence of serious postoperative complications (53% vs. 30%; P = 0.001) and experienced a longer hospital stay [19.00 (15.00-24.50) vs. 17.00 (14.00-20.00); P < 0.05]. Notably, an mFI-5 score greater than 2 emerged as an independent risk factor for severe postoperative complications (odds ratio: 2.297; 95% confidence interval: 1.216 to 4.339; P = 0.01). Furthermore, the mFI-5 score displayed predictive capabilities for severe postoperative complications with an area under the receiver operating characteristic (ROC) curve of 0.629 (95% confidence interval: 0.551 to 0.707; P < 0.05). CONCLUSION: The mFI-5 demonstrates a high level of sensitivity in predicting serious complications, prolonged hospital stays, and mortality following radical resection of colorectal carcinoma. As a practical clinical assessment tool, the mFI-5 enables the identification of high-risk patients and facilitates preoperative optimization.
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Huang et al. (2023) studied this question.
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