ArticleSurgery2026
The impact of frailty on postoperative outcomes of veterans with stage I non-small cell lung cancer.
Article in Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Preoperative Frailty Assessment: An Important Component of Preoperative Planning for Lung Cancer Surgery.Annals of surgical oncology · 2026Article
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17 authors.
Funding
Abstract
backgroundAlthough surgical resection is the standard of care for early-stage non-small cell lung cancer, frailty influences treatment decisions. We evaluated the prognostic utility of the Veterans Affairs Frailty Index, a claims-based assessment tool, among veterans undergoing resection for stage I non-small cell lung cancer.
methodsWe conducted a retrospective cohort study of veterans who underwent curative-intent surgery for stage I non-small cell lung cancer in the Veterans Health Administration from 2006 to 2020. Using the Veterans Affairs Frailty Index, frailty was categorized as follows: nonfrail (≤0.1), prefrail (0.1-0.2), mildly frail (0.2-0.3), moderately frail (0.3-0.4), and severely frail (>0.4). The primary outcome was overall survival, assessed using multivariable Cox regression. Secondary outcomes included major complications, prolonged hospitalization, 30-day readmission, 90-day mortality, and recurrence.
resultsAmong 12,271 veterans, 7.7% were severely frail. Compared with nonfrail patients, severely frail patients were older (mean age 70.3 years vs 64.7 years; P < .001) and were more likely to undergo minimally invasive surgery (57.7% vs 37.8%) and sublobar resection (41.2% vs 22.3%) (all P < .001). Severe frailty was independently associated with higher risk of major complications (adjusted odds ratio 2.85, 95% confidence interval 2.18-3.71), prolonged hospitalization (adjusted odds ratio 2.67), 30-day readmission (adjusted odds ratio 1.76), 90-day mortality (adjusted odds ratio 2.87), and worse overall survival (adjusted hazard ratio 2.20, 95% confidence interval 1.97-2.46; all P < .001). Recurrence was not significantly associated with frailty (adjusted hazard ratio 0.87; P = .410).
conclusionFrailty, as measured by the Veterans Affairs Frailty Index, independently predicts adverse postoperative and survival outcomes following resection for stage I non-small cell lung cancer. Preoperative frailty assessment may improve risk stratification and guide surgical decision making.
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