Frailty assessment for risk stratification in pancreatic surgery

Area of Science:

• Oncology
• Geriatric Medicine
• Surgical Outcomes

Background:

• Pancreatic cancer predominantly affects individuals over 65.
• Frailty, characterized by comorbidities and functional decline, is a risk factor for surgical complications.

Purpose of the Study:

• To evaluate the impact of frailty on postoperative recovery following pancreatic surgery.

Main Methods:

• Retrospective analysis of 190 patients undergoing pancreatic resections (Jan 2015-Dec 2023).
• Frailty assessed using the modified frailty index (mFI); mFI > 0.27 defined frailty.
• Complications graded using Clavien-Dindo Classification and Comprehensive Complication Index.

Main Results:

• 14% of patients were classified as frail, with male gender associated with frailty.
• Frail patients experienced increased intensive care unit (ICU) stays and higher rates of grade C postoperative pancreatic fistula (POPF).
• Frailty correlated with a higher Comprehensive Complication Index (CCI) and increased hospitalization costs.

Conclusions:

• Frailty is linked to increased morbidity after pancreatic resections.
• Preoperative frailty assessment is recommended for risk stratification in pancreatic surgery patients.