AB155. SOH26AB_0443. A retrospective analysis of frailty as a predictor of post-operative outcomes and functional decline in patients undergoing major colorectal resections

Background: Frailty is defined as the reduction in physiological reserve across multiple systems. The phenomenon of cancer frailty is described when cancer and frailty coexist in a patient. The cancer and its related symptoms accelerate the progression of baseline frailty. According to the European Cancer Information System, there is an increasing burden of cancer within the European Union. This can be attributed to the ageing population. The increase in the onco-geriatric surgical population represents a challenge to surgical services. Current Literature suggest that that routine geriatric involvement improves outcomes in high-risk older surgical patients. This study aimed to determine the utility of frailty as a predictor of postoperative outcomes.

Methods: The primary outcome of this study was to assess the incidence of major complications at 30 and 90 days in patients over the age of 65 years undergoing major colorectal resections. The secondary outcomes were the length of stay, postoperative delirium, readmission rate, and destination of discharge, i.e., to home versus nursing home or long-term care. A single-centre retrospective chart review of patients over the age of 65 years who underwent major colorectal resections for colorectal malignancy from January 2024 to July 2025 at University Hospital Waterford was conducted. In conjunction with our geriatricians, we retrospectively assessed the level of frailty of these patients by applying a clinical frailty scoring system based on pre-existing data of their functional baseline.

Results: A total of 133 patients underwent major colorectal resections. Seventy-eight patients were male, and 56 patients were female. Seventy patients underwent anterior resection, 42 patients underwent right hemicolectomies, 5 patients underwent left hemicolectomies, and 16 patients underwent abdominoperineal resections. Sixty-nine patients were robotic-assisted, 56 patients were laparoscopic, and 8 patients were open operations. The average age of patients was 65 years. The average length of hospital stay was 11 days. We propose that the higher clinical frailty scoring indices will be associated with increased morbidity and mortality post-major colorectal surgery.

Conclusions: Pre-operative frailty is a recognised predictor of adverse postoperative outcomes and functional decline. An established model of care amongst general surgeons and geriatricians to deliver care to high-risk elderly patients is crucial in the rising onco-geriatric population.

Keywords: Oncogeriatric; frailty; functional decline; colorectal surgery; clinical scoring indices