Journal of Clinical Medicine
Association Between the Preoperative Modified Frailty Index-5 and Cumulative Morbidity After Colorectal Cancer Resection: A Single-Center Retrospective Cohort Study Based on the Comprehensive Complication Index
By İshak Aydın, Burak Aydoğan, Orçun Yalav and 6 others.
Abstract
Objective
This study evaluated the association between the preoperative 5-factor Modified Frailty Index (mFI-5) and in-hospital cumulative postoperative morbidity, as measured by the Comprehensive Complication Index (CCI), in patients undergoing colorectal cancer resection.
Methods
This retrospective, single-center cohort study included 455 patients who underwent resection for colorectal cancer between January 2015 and April 2021. Patients were classified as mFI-5 = 0, mFI-5 = 1, or mFI-5 ≥ 2. The primary outcome was high cumulative morbidity during the index hospitalization, defined as CCI ≥ 26.2. Associations with categorical outcomes were evaluated using multivariable logistic regression. Deviation from a linear trend was assessed using a likelihood ratio test, and sensitivity analyses were performed after excluding patients who died, restricting the analysis to elective patients, and using Firth penalized logistic regression. An exploratory interaction between categorical mFI-5 and emergency surgery was assessed using Firth penalized logistic regression.