Frailty Predicts Severe Postoperative Complication after Elective Hepatic Resection

Area of Science:

• Geriatric Surgery
• Surgical Oncology
• Clinical Frailty Assessment

Background:

• Elderly patients undergoing hepatectomy are presumed to have higher complication rates.
• The predictive value of frailty in this context requires further confirmation.

Purpose of the Study:

• To determine the significance of clinical frailty (CF) in predicting severe postoperative complications after hepatectomy.
• To compare the predictive power of frailty versus sarcopenia for postoperative outcomes.

Main Methods:

• A cohort of 143 patients aged over 65 undergoing hepatectomy (2011-2016) was analyzed.
• Clinical frailty was defined using the CF scale (score >4).
• Sarcopenia was quantified by muscle area on CT scans.

Main Results:

• Clinical frailty was identified in 11% of patients and was associated with advanced age, severe complications (Clavien-Dindo ≥3), and longer hospital stays.
• Sarcopenia did not show a significant association with postoperative outcomes.
• Logistic regression confirmed CF as an independent predictor of severe complications (RR 4.2, p=0.017), with higher rates of organ/space surgical site infection in frail patients.

Conclusions:

• Clinical frailty, not sarcopenia, serves as a reliable predictor of severe postoperative complications in patients undergoing hepatectomy.
• The findings underscore the importance of assessing clinical frailty for risk stratification in hepatectomy patients.