January 10, 2026Open Access

Role of frailty in otorhinolaryngology and head and neck surgery in a secondary and a tertiary care center: a prospective observational two-cohort study

Q: What does this research mean for the field?

Frailty is an independent predictor of postoperative complications in patients aged 65 years and older undergoing otolaryngology and head and neck surgery. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Key Result

Frailty was identified as an independent predictor of postoperative complications (OR = 1.805; p = 0.049) in patients ≥ 65 years undergoing otolaryngology surgery.

Key Points

To evaluate frailty as a predictor of perioperative complications in elderly patients undergoing otorhinolaryngology and head and neck surgery.
Conducted a prospective observational study with two cohorts in secondary and tertiary care centers.
Included 276 patients aged ≥65 years undergoing surgery from 2022 to 2023.
Assessed frailty using the Groningen Frailty Indicator questionnaire.
Analyzed complications using the Clavien-Dindo classification with regression models.
34.7% of patients were identified as frail.
Female gender and Charlson Comorbidity Index were independent predictors of frailty.
22.8% of patients experienced postoperative complications.
Frailty was an independent predictor of complications with an odds ratio of 1.805.

Structured PICO

Does frailty predict postoperative complications in elderly patients undergoing otorhinolaryngology and head and neck surgery?

Population

276 elderly patients (≥ 65 years of age) undergoing otolaryngology and head and neck surgery (OLHNS) in a secondary and a tertiary care hospital, 67% male, median age 74 years, Charlson Comorbidity Index (CCI) 2+: 85%.

Intervention

Frailty assessment using the Groningen Frailty Indicator (GFI) questionnaire

Comparator

Non-frail patients (GFI score ≤3)

Outcome

Postoperative complications measured with the Clavien-Dindo classification (CDC)safety

Frailty and a Charlson Comorbidity Index of 2 or higher are independent predictors of postoperative complications in elderly patients undergoing otorhinolaryngology and head and neck surgery.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract The proportion of elderly patients undergoing otolaryngology and head and neck surgery (OLHNS) is continuously increasing. The present prospective study evaluated whether frailty in patients ≥ 65 years of age was an important predictor of perioperative complications. An unselected series of 276 elderly patients (67% male; median age: 74 years; Charlson Comorbidity Index (CCI) 2+: 85%) undergoing OLHNS surgery in a 6-month period in 2022 and 2023, respectively, in a secondary and in a tertiary care hospital completed the Groningen Frailty Indicator questionnaire. Primary outcome measure was postoperative complications measured with the Clavien-Dindo classification (CDC), which were analyzed using univariate and multivariate binary logic regression models. 34.7% of the patients were frail. Female gender (Odds ratio OR = 2.158; confidence interval CI = 1.229 to 3.791; p = 0.007) and the CCI (OR = 1.258; CI = 1.135 to 1.396; p < 0.001) were independent predictors for frailty. 22.8% had CDC complications. Frailty (OR = 1.805; CI = 1.001 to 3.252; p = 0.049) and a CCI 2+ (OR = 4.821; CI = 1.102 to 21.079; p = 0.037) were independent predictors for postoperative CDC complications. The inclusion of a frailty assessment into the pre-operative risk assessment is recommended for all patients ≥ 65 years of age planned for OLHNS.

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