TPW 2.12 Can Biomarkers of Vital Signs and Blood Results Alone Predict Post-Operative Outcomes in Colorectal Cancer Resection Patients?

Abstract

Frailty in surgical patients is difficult to objectively quantify without bias. The FI-Lab is a laboratory-based frailty index derived from routine blood tests and physiological numerical variables only. Validated in medical cohorts, its role in predicting postoperative outcomes following colorectal cancer resection has not been well explored. This retrospective cohort study included octogenarian patients undergoing colorectal cancer resection at a tertiary centre between 2011 and 2017. FI-Lab scores were calculated by summing variable-specific deficits and dividing by the total number of variables, generating a score from 0 to 1, with higher values indicating greater frailty. Patients were stratified into Low (≤0.20), Moderate (0.21–0.40), and High (>0.40) frailty groups. Postoperative mortality at 1, 2, and 5 years was analysed using univariable comparisons and logistic regression. A total of 337 patients were included. The overall mean FI-Lab score was 0.241 (range 0.00–0.70). Patients who died within 1 year had significantly higher average FI-Lab scores than survivors (0.319 vs 0.233, p=0.007), with similar associations at 2 years (p=0.020) but not at 5 years. Mortality increased stepwise across frailty groups at 1 year (5.2%, 8.1%, 21.3%; p=0.003) and 5 years (34.2%, 31.1%, 51.1%; p=0.044). On logistic regression, High frailty was significantly associated with greater odds of 1-year (OR 4.62) 2-year (OR 2.34), and 5-year mortality (OR 2.08) compared to Low frailty (p<0.05). The use of FI-lab in objectively quantifying frailty could be extended to peri-operative risk stratification for elderly colorectal cancer resection patients.