Previously submitted to: JMIR Medical Informatics (no longer under consideration since Feb 03, 2025)
Date Submitted: Jan 10, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Higher hospital frailty risk score is predictive of 90-day readmission after minimally invasive colorectal cancer surgery: A National Readmission Database analysis
ABSTRACT
Background:
Minimally invasive procedures are common in colorectal cancer (CRC) surgeries, but the impact of frailty on postoperative outcomes is unclear.
Objective:
This study aimed to assess how frailty status affects postoperative outcomes after minimally invasive CRC surgery.
Methods:
This study examined the impact of frailty on postoperative outcomes following minimally invasive colorectal cancer (CRC) surgery. Using data from the 2016–2020 U.S. National Readmission Database, the study analyzed patients aged ≥60 who underwent minimally invasive surgery for CRC. Patients were categorized into low, intermediate, and high frailty risk groups based on the Hospital Frailty Risk Score (HFRS). Outcomes assessed included 90-day readmissions, in-hospital mortality, and complications.
Results:
The analysis of 6,417 patients revealed that intermediate frailty was associated with higher in-hospital mortality (OR = 2.01), and high frailty had an even greater risk (OR = 3.83). Frailty also showed a dose-response relationship with complications, with the odds of complications being significantly higher in both intermediate (OR = 4.59) and high frailty groups (OR = 37.12). Only the high frailty group had an elevated risk of 90-day readmission (OR = 1.27). Certain subgroups, such as patients aged <80, without diabetes or chronic kidney disease, with rectal tumors, and those undergoing robotic surgery, were particularly affected by frailty in terms of in-hospital mortality.
Conclusions:
The study highlights that higher frailty, as measured by the HFRS, is a strong predictor of adverse postoperative outcomes and early readmission in older patients undergoing minimally invasive CRC surgery, with especially notable effects in certain subgroups.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.