Frailty is a useful predictive marker of postoperative complications after pancreaticoduodenectomy

Abstract

BACKGROUND: Frailty results in a high risk for disability, hospitalization, and mortality. This study aimed to investigate perioperative details of frail patients who underwent pancreatectomy and whether frailty can be a predictive factor of postoperative complications, especially of clinically relevant postoperative pancreatic fistula (CR-POPF).METHODS: This retrospective study included patients who underwent pancreatectomy in our hospital between August 2016 and March 2019. The patients were divided into frail and pre-/non-frail groups. The diagnostic criteria were based on the Japanese version of the Cardiovascular Health Study.RESULTS: Of 93 patients, 11 (11.8%) and 82 (88.2%) were frail and pre-/non-frail patients, with median ages of 82 and 72 years, respectively (p=0.041). Postoperative complications (Clavien-Dindo ≧IIIa) were found in 8 and 32 patients (p=0.034), CR-POPF in 3 and 13 patients (p=0.346), and postoperative hospital stays were 21 and 17 days (p=0.041), respectively. On multivariate analysis, frailty was an independent predictive factor (odds ratio [OR] 5.604, 95.0% confidence interval [CI] 1.002-30.734; p=0.047) of postoperative complications (Clavien-Dindo ≧IIIa) after pancreaticoduodenectomy. On multivariate analysis, a soft pancreas (OR 5.696, 95.0% CI 1.142-28.149; p=0.034) was an independent and significant predictive factor of CR-POPF after pancreaticoduodenectomy.CONCLUSIONS: Frailty may be a useful predictive factor of postoperative complications in patients undergoing pancreaticoduodenectomy.