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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...

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Identifying Frailty Using Point-of-Care Ultrasonography: Image Acquisition and Assessment
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Preoperative Frailty Screening and Risk Prediction Model in Elderly Patients Undergoing Hepatectomy: A

Xiaoyan Chen1, Laigui Lu2, Tianyu Zhao1

  • 1School of Nursing, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China.

Clinical Interventions in Aging
|July 15, 2026
PubMed
Summary

A new frailty screening model for elderly patients undergoing liver resection identified older age, higher ASA, and elevated NRS-2002 as risk factors. Preoperative frailty impacts postoperative outcomes, necessitating targeted management.

Keywords:
analysis of influencing factorselderlyfrailtyhepatectomy

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Area of Science:

  • Geriatric Medicine
  • Surgical Oncology
  • Clinical Risk Assessment

Background:

  • Frailty is a significant concern in elderly patients undergoing major surgery.
  • Effective preoperative screening is crucial for optimizing outcomes in hepatectomy patients.

Purpose of the Study:

  • To develop and validate a preoperative frailty screening and risk prediction model for elderly patients undergoing hepatectomy.
  • To identify clinical indicators associated with frailty in this population.

Main Methods:

  • Prospective observational study of 216 elderly patients (≥60 years) undergoing liver resection.
  • Data collection included frailty assessments, clinical markers, and demographics.
  • Univariate and multivariate binary logistic regression analyses were used to identify frailty predictors.

Main Results:

  • 24.1% of patients exhibited frailty (FRAIL score ≥2).
  • Older age, higher ASA classification, and elevated NRS-2002 score were independent risk factors for frailty.
  • Higher MET levels and albumin concentrations were protective factors.
  • The prediction model demonstrated excellent discrimination (AUC = 0.923).
  • Frailty was linked to longer hospital stays and increased reoperation rates.

Conclusions:

  • Preoperative frailty in elderly hepatectomy patients is associated with identifiable clinical indicators.
  • Despite a low overt frailty rate (5.6%), rigorous screening is essential.
  • Perioperative management should focus on pre-frail patients, with individualized plans for frail patients.