An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ASA | American Society of Anesthesiologists |
FRAIL | Fatigue, Resistance, Ambulation, Illness, and Loss of Weight |
RFT/TL | Rectus femoris thickness/thigh length |
SD | Standard deviation |
STAR | Sonographic Thigh Adjustment Ratio |
TMT/TL | Total muscle thickness/thigh length |
USG | Ultrasonography |
VIT/TL | Vastus intermedius thickness/thigh length |
BMI | Body mass index |
CDC | Clavien–Dindo Classification |
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Scale Items | Score | ||
---|---|---|---|
Fatigue | How often have you felt tired in the past four weeks? | Most of the time or all of the time = 1 | Normal = 0 |
Resistance | By yourself and not using aids, can you climb one flight of stairs? | No = 1 | Yes = 0 |
Ambulation | By yourself and not using aids, do you have any difficulty walking 200 m? | No = 1 | Yes = 0 |
Illness | Do you have a history of hypertension, diabetes mellitus, chronic obstructive pulmonary disease, myocardial infarction, congestive heart failure, angina, asthma, arthritis, stroke, kidney disease, or cancer? (The score is based on whether the patient has 5 or more of these 11 conditions.) | Yes = 1 | No = 0 |
Loss of weight | Have you lost more than 5% of your body weight in the past year? | Yes = 1 | No = 0 |
Total …/5 |
Scale Item | Score | |
---|---|---|
Activity | Able to move all four extremities | 2 |
Able to move two extremities | 1 | |
Unable to move extremities | 0 | |
Respiration | Able to breathe and cough | 2 |
Dyspneic or has restricted breathing | 1 | |
Apneic | 0 | |
Circulation | Blood pressure within ±20% of pre-anesthetic level | 2 |
Blood pressure within ±20–49% of pre-anesthetic level | 1 | |
Blood pressure within ±50% of pre-anesthetic level | 0 | |
Consciousness | Fully awake, oriented, and cooperative | 2 |
Responds to verbal stimuli | 1 | |
No response | 0 | |
Oxygen saturation | SpO2 > 92% in room air | 2 |
Requires oxygen support to maintain SpO2 > 90% | 1 | |
SpO2 < 90% despite oxygen support | 0 |
Grade | Complication |
---|---|
1 | Normal postoperative follow-up that does not require pharmacological, surgical, or radiological intervention (use of antiemetics, antipyretics, analgesics, diuretics, physiotherapy, and electrolytes is acceptable; bedside wound infections are also considered within this category) |
2 | Complications requiring medical treatment beyond those listed in Grade 1 (blood transfusions, total parenteral nutrition (TPN), and antibiotic use are acceptable) |
3A | Complications requiring intervention under regional/local anesthesia |
3B | Complications requiring intervention under general anesthesia |
4A | Complications leading to single-organ dysfunction requiring intensive care unit admission |
4B | Complications leading to multiple organ failure |
5 | Patient death |
Variable | Mean ± SD or n (%) | |
---|---|---|
Age (years) | 69.8 ± 7.26 | |
Body mass index (kg/m2) | 26.2 ± 4.77 | |
Gender | Male | 29 (69%) |
Female | 13 (31%) | |
Frailty status | Not frail | 6 (14%) |
Pre-frail | 26 (62%) | |
Frail | 10 (24%) | |
Education level | No formal education | 3 (7%) |
Primary school graduate | 21 (50%) | |
Middle school graduate | 6 (14%) | |
High school graduate | 9 (21%) | |
University graduate | 3 (7%) | |
Marital status | Married | 32 (76%) |
Widowed | 10 (24%) | |
Sarcopenic status | Sarcopenic male | 26 (62%) |
Non-sarcopenic male | 3 (7%) | |
Sarcopenic female | 8 (19%) | |
Non-sarcopenic female | 5 (12%) |
ASA I (n = 1) | ASA II (n = 18) | ASA III (n = 23) | p-Value | ||
---|---|---|---|---|---|
Age (years) | 68.0 ± 0 | 66.9 ± 5.88 | 72.1 ± 7.68 | 0.0956 | |
Weight (kg) | 85.0 ± 0 | 71.2 ± 12.3 | 74.7 ± 15.7 | 0.4 | |
Height (cm) | 174 ± 0 | 166 ± 8.70 | 168 ± 10.4 | 0.438 | |
Body mass index (kg/m2) | 28.1 ± 0 | 25.8 ± 4.23 | 26.5 ± 5.31 | 0.786 | |
Anesthesia recovery time | 32.0 ± 0 | 34.9 ± 5.44 | 38.2 ± 7.15 | 0.265 | |
CDC grade | 1 | 0 (0%) | 1 (6%) | 1 (4%) | 0.956 |
2 | 1 (100%) | 15 (83%) | 16 (70%) | ||
3A | 0 (0%) | 0 (0%) | 0 (0%) | ||
3B | 0 (0%) | 1 (6%) | 1 (4%) | ||
4A | 0 (0%) | 1 (6%) | 4 (17%) | ||
4B | 0 (0%) | 0 (0%) | 0 (0%) | ||
5 | 0 (0%) | 0 (0%) | 1 (4%) | ||
Discharge time (days) | 6.00 ± 0 | 12.2 ± 17.2 | 10.5 ± 6.12 | 0.303 | |
Sarcopenia | Present | 1 | 14 | 19 | 0.954 |
Absent | 0 | 4 | 4 | ||
Frailty status | Not frail | 1 | 5 | 0 | p < 0.05 * |
Pre-frail | 0 | 12 | 14 | ||
Frail | 0 | 1 * | 9 * |
Not Frail | Pre-Frail | Frail | p-Value | ||
---|---|---|---|---|---|
Age | 67.5 ± 4.09 | 68.1 ± 6.67 | 75.6 ± 7.62 * | p < 0.05 * | |
Gender | Male | 4 (67%) | 18 (69%) | 7 (70%) | 0.99 |
Female | 2 (33%) | 8 (31%) | 3 (30%) | ||
Body mass index | 24.4 ± 1.97 | 27.1 ± 4.33 | 24.9 ± 6.55 | 0.135 | |
Education level | No formal education | 0 (0%) | 2 (8%) | 1 (10%) | 0.893 |
Primary school | 2 (33%) | 13 (50%) | 6 (60%) | ||
Middle school | 1 (17%) | 4 (15%) | 1 (10%) | ||
High school | 2 (33%) | 6 (23%) | 1 (10%) | ||
University | 1 (17%) | 1 (4%) | 1 (10%) | ||
Marital status | Married | 5 (83%) | 22 (85%) | 5 (50%) | 0.083 |
Widowed | 1 (17%) | 4 (15%) | 5 (50%) | ||
Anesthesia recovery time | 34.0 ± 4.94 | 35.5 ± 5.43 | 41.6 ± 8.38 | 0.056 | |
Discharge time | 7.17 ± 2.99 | 12.2 ± 14.5 | 10.8 ± 7.74 | 0.199 | |
CDC grade | 1 | 0 (0%) | 2 (8%) | 0 (0%) | 0.244 |
2 | 6 (100%) | 20 (77%) | 6 (60%) | ||
3A | 0 (0%) | 0 (0%) | 0 (0%) | ||
3B | 0 (0%) | 2 (8%) | 0 (0%) | ||
4A | 0 (0%) | 2 (8%) | 3 (30%) | ||
4B | 0 (0%) | 0 (0%) | 0 (0%) | ||
5 | 0 (0%) | 0 (0%) | 1 (10%) | ||
Sarcopenia | Present | 1 (3%) | 14 (41%) | 19 (56%) | |
Absent | 0 (0%) | 4 (50%) | 4 (50%) | ||
Total muscle thickness | 2.74 ± 0.413 | 2.79 ± 0.614 * | 2.27 ± 0.446 * | p < 0.05 * |
Sarcopenic Female | Non-Sarcopenic Female | Sarcopenic Male | Non-Sarcopenic Male | p-Value | ||
---|---|---|---|---|---|---|
Age | 65.0 ± 7.27 * | 71.0 ± 8.51 | 71.9 ± 6.33 * | 62.7 ± 4.62 | p < 0.05 * | |
Body mass index | 28.9 ± 4.25 | 24.2 ± 5.31 | 25.9 ± 4.52 | 25.2 ± 7.05 | 0.239 | |
Education level | No formal education | 2 (25%) | 0 (0%) | 1 (4%) | 0 (0%) | 0.839 |
Primary school | 4 (50%) | 4 (80%) | 11 (42%) | 2 (67%) | ||
Middle school | 1 (12%) | 0 (0%) | 5 (19%) | 0 (0%) | ||
High school | 0 (0%) | 0 (0%) | 8 (31%) | 1 (33%) | ||
University | 1 (12%) | 1 (20%) | 1 (4%) | 0 (0%) | ||
Marital status | Married | 5 (62%) | 3 (60%) | 21 (81%) | 3 (100%) | 0.083 |
Widowed | 3 (38%) | 2 (40%) | 5 (19%) | 0 (0%) | ||
Anesthesia recovery time | 37.3 ± 4.30 | 37.8 ± 7.18 | 36.3 ± 7.60 | 35.3 ± 3.06 | 0.918 | |
Discharge time | 7.00 ± 1.93 | 22.0 ± 32.4 | 10.4 ± 6.10 | 10.0 ± 2.65 | 0.278 | |
CDC grade | 1 | 0 (0%) | 1 (20%) | 1 (4%) | 0 (0%) | 0.244 |
2 | 8 (100%) | 3 (60%) | 18 (69%) | 3 (100%) | ||
3A | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | ||
3B | 0 (0%) | 1 (20%) | 1 (4%) | 0 (0%) | ||
4A | 0 (0%) | 0 (0%) | 5 (19%) | 0 (0%) | ||
4B | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | ||
5 | 0 (0%) | 0 (0%) | 1 (4%) | 0 (0%) |
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Share and Cite
Özdemir, R.; Yaman, F. An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery. Medicina 2025, 61, 969. https://doi.org/10.3390/medicina61060969
Özdemir R, Yaman F. An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery. Medicina. 2025; 61(6):969. https://doi.org/10.3390/medicina61060969
Chicago/Turabian StyleÖzdemir, Rüştü, and Ferda Yaman. 2025. "An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery" Medicina 61, no. 6: 969. https://doi.org/10.3390/medicina61060969
APA StyleÖzdemir, R., & Yaman, F. (2025). An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery. Medicina, 61(6), 969. https://doi.org/10.3390/medicina61060969