Preoperative frailty risk in older patients with colorectal cancer admitted to the ICU after surgery: prevalence, associated factors, and association with in-hospital outcomes
5 affiliations
- 1School of Nursing, Ningxia Medical University
- 2Department of Trauma Orthopedics, General Hospital of Ningxia Medical University
- 3Department of Critical Care Medicine, Cardio-cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University
- 4Department of First Department of Surgical Oncology, General Hospital of Ningxia Medical University
- 5Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Abstract
Introduction: Frailty is recognized as an important predictor of adverse outcomes in older surgical patients. However, evidence regarding preoperative frailty among older patients with colorectal cancer (CRC) admitted to the ICU after surgery remains limited. This study aimed to investigate the prevalence, associated factors, and impact of preoperative frailty risk on in-hospital outcomes in this high-risk population.
Materials and methods: This single-center retrospective cohort study included 308 older CRC patients who underwent radical surgery and were admitted to the ICU postoperatively between June 2023 and March 2026. Preoperative frailty risk was assessed using the five-item modified Frailty Index (mFI-5). Multivariable logistic regression was used to identify factors associated with frailty risk and evaluate the association between preoperative frailty risk and postoperative complications. Generalized linear models were applied to assess the associations of frailty risk with total hospital stay, ICU stay, and hospitalization costs.
Results: The prevalence of preoperative frailty risk was 55.52% in this study. Higher albumin levels were a protective factor, whereas higher blood glucose levels, elevated NLR, BMI ≥ 26.9 kg/m², polypharmacy, pain, and high fall risk were significantly associated with increased frailty risk. After adjustment for confounders, frailty risk remained an independent predictor of overall complications and severe complications and was significantly associated with prolonged total hospital stay, longer ICU stay, and increased hospitalization costs.
Discussion: Preoperative frailty risk is highly prevalent among older CRC patients admitted to the ICU after surgery and is independently associated with adverse in-hospital outcomes. These findings highlight the importance of incorporating frailty assessment into perioperative management. The mFI-5 is a simple and feasible tool for preoperative risk stratification in this high-risk population and may help guide prehabilitation strategies to ultimately optimize postoperative recovery.
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BibTeX
@article{wang2026preoperative,
title = {{Preoperative frailty risk in older patients with colorectal cancer admitted to the ICU after surgery: prevalence, associated factors, and association with in-hospital outcomes}},
author = {Yongqin Wang and Guifang Li and Qiuyan Yang and Meng Yin and Xingyu Yang and Jiaying Li},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1948607},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1948607/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Preoperative frailty risk in older patients with colorectal cancer admitted to the ICU after surgery: prevalence, associated factors, and association with in-hospital outcomes
AU - Yongqin Wang
AU - Guifang Li
AU - Qiuyan Yang
AU - Meng Yin
AU - Xingyu Yang
AU - Jiaying Li
PY - 2026
DA - 2026/10/26
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1948607
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1948607/full
AB - Introduction: Frailty is recognized as an important predictor of adverse outcomes in older surgical patients. However, evidence regarding preoperative frailty among older patients with colorectal cancer (CRC) admitted to the ICU after surgery remains limited. This study aimed to investigate the prevalence, associated factors, and impact of preoperative frailty risk on in-hospital outcomes in this high-risk population. Materials and methods: This single-center retrospective cohort study included 308 older CRC patients who underwent radical surgery and were admitted to the ICU postoperatively between June 2023 and March 2026. Preoperative frailty risk was assessed using the five-item modified Frailty Index (mFI-5). Multivariable logistic regression was used to identify factors associated with frailty risk and evaluate the association between preoperative frailty risk and postoperative complications. Generalized linear models were applied to assess the associations of frailty risk with total hospital stay, ICU stay, and hospitalization costs. Results: The prevalence of preoperative frailty risk was 55.52% in this study. Higher albumin levels were a protective factor, whereas higher blood glucose levels, elevated NLR, BMI ≥ 26.9 kg/m², polypharmacy, pain, and high fall risk were significantly associated with increased frailty risk. After adjustment for confounders, frailty risk remained an independent predictor of overall complications and severe complications and was significantly associated with prolonged total hospital stay, longer ICU stay, and increased hospitalization costs. Discussion: Preoperative frailty risk is highly prevalent among older CRC patients admitted to the ICU after surgery and is independently associated with adverse in-hospital outcomes. These findings highlight the importance of incorporating frailty assessment into perioperative management. The mFI-5 is a simple and feasible tool for preoperative risk stratification in this high-risk population and may help guide prehabilitation strategies to ultimately optimize postoperative recovery.
SN - 2234-943X
ER -