Application of MFI-5 assessment in severe complications and unfavourable outcomes after radical resection of colorectal cancer

Abstract

BACKGROUND/OBJECTIVE Frailty " is a hallmark of physiologic decline of multiple organ systems and places elderly colorectal cancer patients at increased risk for poor prognosis. While 11 modified frailty indices (MFI-11) have been shown to predict adverse outcomes after radical resection of colorectal cancer, 5 modified frailty indices (MFI-5) have not been studied in this population. Methods Retrospective analysis of patients over 65 years of age who underwent radical resection of colorectal cancer. The MFI-5 score was calculated for each patient, and an MFI-5 score ≥ 2 was defined as frailty. Univariate and multivariate analyses the MFI-5 were performed to determine the value of adverse outcomes and complications after surgery. Results The incidence of serious postoperative complications (53% vs. 30%; P = 0.001) and length of hospital stay [19.00 (15.00-24.50) vs. 17.00 (14.00–20.00); P < 0.05] were significantly prolonged in patients with a MFI5 score ≥ 2. MFI-5 score greater than 2 was an independent risk factor for severe postoperative complications (odds ratio 2.297; 95% confidence interval 1.216 to 4.339; P = 0.01) and an MFI-5 score predicted severe postoperative complications with an area under the ROC curve of 0.629 (95% confidence interval 0.551 to 0.707; P < 0.05). Conclusion The MFI-5 is a sensitive tool for predicting serious complications, prolonged hospital stay, and mortality after radical resection of colorectal carcinoma. The MFI-5 is a practical clinical assessment tool for identifying high-risk patients and supporting preoperative optimization.