BACKGROUND Frail patients are likely to suffer from postoperative complication, but this assumption has not been well confirmed. OBJECTIVES This study aims to clarify the importance of frailty in patients undergoing hepatectomy for predicting severe postoperative complications. METHOD One hundred and forty-three patients aged >65 years undergoing hepatectomy between 2011 and 2016 were enrolled in this study. The relevance of frailty versus sarcopenia for postoperative outcome was assessed. We defined clinical frailty (CF) as a CF scale >4. Sarcopenia was defined by the total muscle area at the level of the third lumbar vertebra measured on computed tomography. RESULTS There were 16 patients (11%) with CF and 80 patients (56%) with sarcopenia. CF was associated with high age (p < 0.0001), severe postoperative complications (Clavien-Dindo classification ≥3) (p = 0.0059), and postoperative in-hospital stay (p = 0.0013). On the other hand, sarcopenia was not associated with postoperative outcome. Logistic regression analysis revealed that only CF was an independent predictor of severe postoperative complication (risk ratio of 4.2; p = 0.017). The occurrence of organ/space surgical site infection was significantly higher in the frailty group than in the non-frailty group. CONCLUSION CF, but not sarcopenia, is a robust predictor of severe postoperative complications for patients undergoing hepatectomy.

中文翻译：

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虚弱可预测择期肝切除术后严重的术后并发症。

背景 体弱的患者可能会出现术后并发症，但这一假设尚未得到很好的证实。目的 本研究旨在阐明接受肝切除术的患者虚弱对于预测严重术后并发症的重要性。方法 2011年至2016年间接受肝切除术的年龄>65岁的143例患者被纳入本研究。评估了虚弱与肌肉减少对术后结果的相关性。我们将临床虚弱 (CF) 定义为 CF 量表 >4。肌肉减少症由计算机断层扫描测量的第三腰椎水平的总肌肉面积定义。结果 CF 患者 16 例（11%），肌肉减少症患者 80 例（56%）。CF 与高年龄相关（p < 0.0001），严重的术后并发症（Clavien-Dindo 分级≥3）（p = 0.0059）和术后住院时间（p = 0.0013）。另一方面，肌肉减少症与术后结果无关。Logistic 回归分析显示，只有 CF 是严重术后并发症的独立预测因子（风险比为 4.2；p = 0.017）。衰弱组器官/空间手术部位感染的发生率显着高于非衰弱组。结论 CF，但不是肌肉减少症，是肝切除术患者严重术后并发症的有力预测因素。Logistic 回归分析显示，只有 CF 是严重术后并发症的独立预测因子（风险比为 4.2；p = 0.017）。衰弱组器官/空间手术部位感染的发生率显着高于非衰弱组。结论 CF，但不是肌肉减少症，是肝切除术患者严重术后并发症的有力预测因素。Logistic 回归分析显示，只有 CF 是严重术后并发症的独立预测因子（风险比为 4.2；p = 0.017）。衰弱组器官/空间手术部位感染的发生率显着高于非衰弱组。结论 CF，但不是肌肉减少症，是肝切除术患者严重术后并发症的有力预测因素。