Prognostic value of 11-factor modified frailty index in postoperative adverse outcomes of elderly gastric cancer patients in China

Table 1 Intergroup comparison of demographics, intraoperative information, and mFI-11-related variables in 1003 patients

Variable	mFILow (n = 864)	mFIHigh (n = 139)	P value
Age (yr)			0.0392
65-75	686 (79.4)	102 (73.4)
≥ 75	178 (20.6)	37 (26.6)
Gender, male, n (%)	656 (75.9)	109 (78.4)	0.5222
BMI (kg/m2)	23.47 ± 3.49	24.65 ± 2.97	0.0811
Smokers, n (%)	300 (34.7)	54 (38.8)	0.3452
Drinkers, n (%)	51 (5.9)	18 (12.9)	0.0022
Serum albumin (g/L)	36.05 ± 4.29	27.85 ± 4.56	< 0.0011
Lymphocytes (× 109/L)	0.20 ± 0.11	0.19 ± 0.11	0.5271
PNI	37.03 ± 4.31	28.83 ± 4.58	< 0.0011
TNM stage, n (%)			< 0.0012
I	159 (18.4)	12 (8.6)
II	405 (46.9)	30 (21.6)
II	237 (27.4)	61 (43.9)
IV	63 (7.3)	36 (25.9)
ASA physical stage, n (%)			< 0.0012
I + II	706 (81.71)	78 (56.12)
III + IV	158 (18.29)	61 (43.88)
Gastrectomy, n (%)			0.3612
DG	379 (43.9)	52 (37.4)
PG	117 (13.5)	21 (15.1)
TG	368 (42.6)	66 (47.5)
Surgical approach, n (%)			0.0352
Open	85 (9.8)	15 (10.8)
Robotic surgery	92 (10.6)	25 (18.0)
Laparoscopy	687 (79.5)	99 (71.2)
Surgery duration (min)	202.40 ± 63.07	214.02 ± 62.00	0.0411
Diabetes mellitus	111 (12.8)	78 (56.1)	< 0.0012
Myocardial infarction	10 (1.2)	18 (12.9)	< 0.0012
Cardiac problems	52 (6.0)	27 (19.4)	< 0.0012
Congestive heart failure	1 (0.1)	3 (2.2)	< 0.0012
Cerebrovascular problems	101 (11.7)	44 (31.7)	< 0.0012
Stroke	1 (0.1)	6 (4.3)	< 0.0012
Decreased peripheral pulses	21 (2.4)	29 (20.9)	< 0.0012
Respiratory problems	12 (1.4)	20 (14.4)	< 0.0012
Non-independent functional status	38 (4.4)	27 (19.4)	< 0.0012
Clouding or delirium	43 (5.0)	32 (23.0)	< 0.0012
Arterial hypertension	235 (27.2)	119 (85.6)	< 0.0012
Outcomes
1-year mortality	77 (8.9)	25 (18.0)	0.0012
Admission to ICU	127 (14.7)	44 (31.7)	< 0.0012
Anastomotic fistula	24 (2.8)	11 (7.9)	< 0.0012
6-mo mortality	31 (3.6)	17 (12.2)	< 0.0012

¹t test;

²Pearson χ².

P less than 0.05 is marked as bold. BMI: Body mass index; ASA: American Society of Anesthesiologists; TNM: Tumor-node-metastases; DG: Distal partial gastrectomy; TG: Total gastrectomy; PG: Proximal partial gastrectomy; PNI: Prognostic nutritional index; mFI-11: 11-Item modified frailty index; ICU: Intensive care unit.

Table 2 Multivariate logistic regression analysis of adverse outcomes in elderly patients with gastric cancer after radical treatment

Variable	1-year mortality			6-mo mortality			Anastomotic fistula			Admission to ICU
	B	OR (95%CI)	P value	B	OR (95%CI)	P value	B	OR (95%CI)	P value	B	OR (95%CI)	P value
Age, > 75 yr vs 65-75 yr							0.883	2.418 (1.202-4.865)	0.013	0.914	2.495 (1.723-3.613)	< 0.001
Serum albumin, g/L	-0.532	0.923 (0.900-0.954)	0.023	0.013	0.936 (0.325-0.999)	0.002	-0.881	0.907 (0.484-1.696)	0.759	-0.018	0.718 (0.439-0.909)	0.012
PNI	-0.251	0.925 (0.902-0.964)	0.021	0.041	0.932 (0.554-0.942)	0.014	0.062	0.567 (0.214-1.481)	0.846	-0.019	0.719 (0.438-0.902)	0.041
TNM stage, III vs I	0.324	1.423 (1.004-3.453)	0.005	0.365	1.122 (0.798-2.525)	0.424
TNM stage, IV vs I	0.683	2.422 (1.524-5.292)	0.032	0.415	1.041 (0.698-1.464)	0.221				0.345	1.356 (1.008-4.637)	0.031
ASA grade, II vs I	1.134	1.412 (1.053-2.637)	0.042	0.643	1.001 (0.888-2.642)	0.471				0.980	1.643 (0.463-1.976)	0.318
ASA grade, III vs I	1.124	2.577 (1.656-3.487)	0.011				0.214	1.533 (1.213-4.743)	0.003	0.506	2.344 (1.796-4.785)	0.022
ASA grade, IV vs I	1.412	1.456 (1.077-3.747)	0.041							0.602	2.865 (1.092-3.853)	0.018
Gastrectomy, PG vs TG										0.671	0.312 (0.111-1.764)	0.357
mFI-11Highvs mFI-11Low	0.931	4.432 (2.599-6.343)	0.003	0.887	2.438 (1.075-5.484)	0.033	1.048	2.852 (1.357-5.994)	0.006	0.722	2.058 (1.188-3.563)	0.010

P less than 0.05 is marked as bold. ASA: American Society of Anesthesiologists; BMI: Body mass index; TNM: Tumor- node-metastases; DG: Distal partial gastrectomy; TG: Total gastrectomy; PG: Proximal partial gastrectomy; PNI: Prognostic nutritional index; mFI-11:11-item, modified frailty index; IGA: Intravenous general anesthesia; IIA: Intravenous inhalation anesthesia.