Introduction: There is a dearth of literature on frailty specifically in elderly (aged ≥65 years) gastric cancer patients undergoing gastrectomy. We aim to assess the effects of frailty on postoperative outcomes. Methods: A review of a prospective database was performed from November 2011 to April 2019. Frailty was assessed by multidimensional frailty score (MFS). Outcomes assessed were early postoperative complications and mortality, and length of stay. Results: 289 patients were included. The mean age was 77.3 (range 66–94) years. 183 (63.3%) were males and 172 (59.5%) had early cancer. 275 (95.2%) underwent minimally invasive gastrectomy. 79 (27.3%) patients suffered early postoperative complications, with 47 (16.3%) suffering from Clavien-Dindo grade ≥2 complications. One-year, 90-day, 30-day, and inhospital mortality were 6.6, 1.4, 0.7, and 0%, respectively. 111 (38.4%) of patients were classified as “frail” based on MFS > 5. “Frail” patients were associated with higher 1-year mortality (odds ratio (OR) 4.51, 95% CI 1.57–12.98, p = 0.005) on univariate analysis. On multivariate analysis, “frail” patients did not have significantly increased 1-year mortality. However, when definition of “frail” was changed from MFS > 5 to MFS > 6, frailty was significantly associated with increased 1-year mortality (OR 3.73, 95% CI 1.11–12.53, p = 0.033). Conclusions: Elderly gastric cancer patients undergoing gastrectomy with MFS > 5 do not have increased mortality risk. The influence of frailty on postoperative outcomes may vary based on the risk of the surgical procedure.

中文翻译：

---

接受胃切除术的老年胃癌患者的虚弱

介绍：缺乏关于老年（≥65 岁）胃癌患者胃切除术虚弱的文献。我们旨在评估虚弱对术后结果的影响。方法：对 2011 年 11 月至 2019 年 4 月的前瞻性数据库进行了审查。通过多维虚弱评分 (MFS) 评估虚弱。评估的结果包括术后早期并发症和死亡率以及住院时间。结果：共纳入289例患者。平均年龄为 77.3（范围 66-94）岁。183 人 (63.3%) 是男性，172 人 (59.5%) 患有早期癌症。275 人（95.2%）接受了微创胃切除术。79 名（27.3%）患者出现术后早期并发症，其中 47 名（16.3%）患有 Clavien-Dindo ≥2 级并发症。一年、90 天、30 天和住院死亡率分别为 6.6、1.4、0.7、和 0%，分别。根据 MFS > 5，111 (38.4%) 名患者被归类为“虚弱”患者。“虚弱”患者与较高的 1 年死亡率相关（优势比 (OR) 4.51，95% CI 1.57–12.98，p = 0.005）关于单变量分析。在多变量分析中，“虚弱”患者的 1 年死亡率没有显着增加。然而，当“虚弱”的定义从 MFS > 5 变为 MFS > 6 时，虚弱与 1 年死亡率增加显着相关（OR 3.73，95% CI 1.11–12.53，p = 0.033）。结论：接受胃切除术且 MFS > 5 的老年胃癌患者不会增加死亡风险。虚弱对术后结果的影响可能因外科手术的风险而异。在单变量分析中，“虚弱”患者与较高的 1 年死亡率相关（比值比 (OR) 4.51，95% CI 1.57-12.98，p = 0.005）。在多变量分析中，“虚弱”患者的 1 年死亡率没有显着增加。然而，当“虚弱”的定义从 MFS > 5 变为 MFS > 6 时，虚弱与 1 年死亡率增加显着相关（OR 3.73，95% CI 1.11–12.53，p = 0.033）。结论：接受胃切除术且 MFS > 5 的老年胃癌患者不会增加死亡风险。虚弱对术后结果的影响可能因外科手术的风险而异。在单变量分析中，“虚弱”患者与较高的 1 年死亡率相关（比值比 (OR) 4.51，95% CI 1.57-12.98，p = 0.005）。在多变量分析中，“虚弱”患者的 1 年死亡率没有显着增加。然而，当“虚弱”的定义从 MFS > 5 变为 MFS > 6 时，虚弱与 1 年死亡率增加显着相关（OR 3.73，95% CI 1.11–12.53，p = 0.033）。结论：接受胃切除术且 MFS > 5 的老年胃癌患者不会增加死亡风险。虚弱对术后结果的影响可能因外科手术的风险而异。“虚弱”患者的 1 年死亡率没有显着增加。然而，当“虚弱”的定义从 MFS > 5 变为 MFS > 6 时，虚弱与 1 年死亡率增加显着相关（OR 3.73，95% CI 1.11–12.53，p = 0.033）。结论：接受胃切除术且 MFS > 5 的老年胃癌患者不会增加死亡风险。虚弱对术后结果的影响可能因外科手术的风险而异。“虚弱”患者的 1 年死亡率没有显着增加。然而，当“虚弱”的定义从 MFS > 5 变为 MFS > 6 时，虚弱与 1 年死亡率增加显着相关（OR 3.73，95% CI 1.11–12.53，p = 0.033）。结论：接受胃切除术且 MFS > 5 的老年胃癌患者不会增加死亡风险。虚弱对术后结果的影响可能因外科手术的风险而异。