Correlations of frailty and nutritional risk with postoperative pulmonary infection in elderly patients with gastric cancer

Objective To explore the correlations of preoperative frailty and nutritional risk with postoperative pulmonary infection in elderly patients with gastric cancer.

Methods Elderly patients with confine operation for gastric cancer in the Department of Gastrointestinal Surgery in the Affiliated Hospital of Binzhou Medical University from August 2021 to September 2022 were selected as the research objects, and the Fried Frailty Phenotype Scale and the Nutritional Risk Screening (NRS2002) Assessment Scale were used to evaluate the patient′s frailty and nutritional risk status. Occurrence of postoperative pulmonary infection during hospitalization was observed and recorded, and the effects of frailty and nutritional risk in predicting postoperative pulmonary infection in elderly patients with gastric cancer were analyzed.

Results A total of 217 patients were recruited, including 106 cases (48.85%) with nutritional risk and 72 cases (33.18%) with frailty. Under the same condition of nutritional risk (NRS2002 score ≥ 3), the incidence of postoperative pulmonary infection in patients with frailty was significantly higher than that in patients without frailty (P < 0.01). Logistic regression analysis showed that frailty was an independent risk factor for postoperative pulmonary infection (OR=3.628; 95%CI, 1.528 to 8.611) after correction of relevant factors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for predicting postoperative pulmonary infection in elderly patients with gastric cancer by frailty combined with nutritional risk was 0.834 (95%CI, 0.769 to 0.899), which was significantly higher than 0.763 (95%CI, 0.685 to 0.841) by frailty and 0.737 (95%CI, 0.656 to 0.818) by nutritional risk (P < 0.01).

Conclusion When patients have both frailty and nutritional risk, the risk of postoperative pulmonary infection is the highest; frailty combined with nutritional risk assessment can enhance the predictive efficiency of postoperative pulmonary infection in elderly patients with gastric cancer.