Functional Not Medical Frailty Is Associated With Long-Term Disability After Surgery for Colorectal Cancer

Abstract

Background: Frailty has been associated with increased morbidity after surgery. However, few studies investigate long-term functional outcomes.Methods: Patients ≥ 65 years old who underwent surgery for colorectal cancer were surveyed regarding their ability to perform activities of daily living, measured by Barthel Index, before and after surgery. Patients also reported time to return to their functional baseline.Results: Pre-operative moderate dependency was associated with declining function at six months (OR: 8.8; CI: 1.8-42.6) and one year post-operatively (OR: 17.5; CI: 2.8-109.8). Pre-operative functional frailty was associated with subjective failure to return to baseline (OR: 4.8 and 4.2) for slightly and moderately dependent patients and a longer time to return to baseline. Medical frailty, based on the modified Frailty Index, was not significantly associated with failure to return to baseline.Conclusions: Measures of functional frailty are better predictors of failure to return to baseline, than measures of medical frailty.

Functional outcome and frailty in colorectal surgery patients

“…There was no decline in the BI scores in the non-frail group. Ginesi et al 30 also examined the relationship between BI, frailty, and functional outcomes in cancer surgery patients. Low preoperative BI predicted poor functional outcomes at 6 months and 1 year, however, physical frailty, as assessed by the modified frailty Index (mFI) was not associated with long-term functional decline.…”

“…There was no decline in the BI scores in the non‐frail group. Ginesi et al 30 . also examined the relationship between BI, frailty, and functional outcomes in cancer surgery patients.…”