ArticleFrontiers in medicine2025
Frailty and nutritional assessments for predicting postoperative complications in older adults undergoing non-cardiac surgery.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Preoperative Cognitive Function and Physical Frailty Predict Decision Satisfaction and Postoperative Adherence in Older Gynecologic Oncology Patients: A Prospective Observational Study.Current oncology (Toronto, Ont.) · 2026Observational
- Inflammatory biomarkers and physiological reserve: an explainable machine learning model for predicting postoperative pulmonary complications in elderly laparoscopic surgery.Frontiers in cellular and infection microbiology · 2026Article
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Authors and funding
6 authors.
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Abstract
Introduction: Frailty and malnutrition are closely linked to adverse surgical outcomes. However, their combined influence on post-non-cardiac surgery complications in older patients remains unclear. We aimed to evaluate the predictive value of frailty, malnutrition, and their combined effect on postoperative complications in older patients undergoing intermediate- to high-risk non-cardiac surgery. Methods: This study was a retrospective analysis of data from a prospectively collected cohort that included 637 patients aged ≥60 years. We assessed frailty using the Clinical Frailty Scale (CFS) and nutritional status using the Prognostic Nutritional Index (PNI). The primary outcome was the occurrence of postoperative complications (Clavien-Dindo classification ≥2). We used logistic regression and receiver-operating characteristic (ROC) analyses to determine the predictive accuracy of CFS, PNI, and CFS + PNI. Results: We identified frailty (CFS ≥ 5) in 38.5% of patients, with 29.8% being malnourished (PNI < 45). Multivariate analysis revealed that frailty independently predicted postoperative complications (odds ratio [OR]: 2.09, 95% confidence interval [CI]: 1.09-4.00; Conclusion: Frailty is a strong independent predictor of postoperative complications in older patients undergoing non-cardiac surgery. Although severe malnutrition correlates with increased risk, its effect may be partially mediated by frailty. The integration of frailty and nutritional assessments enhances postoperative complication prediction, underscoring comprehensive geriatric evaluation value in preoperative risk stratification.
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