Frontiers in oncology · 2026
Impact of preoperative handgrip strength and frailty on early postoperative loss of independence in patients with colorectal cancer.
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Zhao Dongqin, He Fan, Liu Hongjiang, Qing Xiaoqing
Аннотация
OBJECTIVE: This study aimed to identify factors associated with early postoperative loss of independence (LOI) and assess the utility of preoperative handgrip strength (HGS) and frailty evaluation among patients undergoing colorectal cancer (CRC) resection.
METHODS: We prospectively evaluated HGS, frailty, and depression among patients with CRC enrolled at our center from February 2024 to February 2025. The associations between HGS and perioperative outcomes were analyzed. Subsequently, a predictive model for postoperative LOI was developed based on the above three variables.
RESULTS: A total of 258 patients with CRC were enrolled, and 60 (23.3%) developed early postoperative LOI. Patients with preoperative low HGS had shorter operative time (p = 0.020) and increased postoperative complications (p = 0.002), particularly pneumonia (p = 0.031). Delayed first defecation (p = 0.008), prolonged time to full oral nutrition (p = 0.024), and extended length of stay (p = 0.002) were also observed in these patients. Multivariate analysis showed that American Society of Anesthesiologists (ASA) score ≥3 [odds ratio (OR) = 2.556, p = 0.019], preoperative moderate frailty (OR = 9.504, p = 0.002), and low HGS (OR = 2.452, p = 0.01) were adverse predictors of LOI. The receiver operating characteristic (ROC) curve revealed a moderate predictive performance of the model, with an area under the curve (AUC) of 0.740 [95% confidence interval (CI): 0.657-0.823].
CONCLUSION: Patients with low HGS are prone to increased postoperative complications and delayed postoperative recovery. Postoperative LOI is independently correlated with ASA score ≥ 3, low HGS, and moderate frailty. Therefore, assessment of frailty and HGS prior to radical resection of CRC facilitates preoperative risk stratification.
METHODS: We prospectively evaluated HGS, frailty, and depression among patients with CRC enrolled at our center from February 2024 to February 2025. The associations between HGS and perioperative outcomes were analyzed. Subsequently, a predictive model for postoperative LOI was developed based on the above three variables.
RESULTS: A total of 258 patients with CRC were enrolled, and 60 (23.3%) developed early postoperative LOI. Patients with preoperative low HGS had shorter operative time (p = 0.020) and increased postoperative complications (p = 0.002), particularly pneumonia (p = 0.031). Delayed first defecation (p = 0.008), prolonged time to full oral nutrition (p = 0.024), and extended length of stay (p = 0.002) were also observed in these patients. Multivariate analysis showed that American Society of Anesthesiologists (ASA) score ≥3 [odds ratio (OR) = 2.556, p = 0.019], preoperative moderate frailty (OR = 9.504, p = 0.002), and low HGS (OR = 2.452, p = 0.01) were adverse predictors of LOI. The receiver operating characteristic (ROC) curve revealed a moderate predictive performance of the model, with an area under the curve (AUC) of 0.740 [95% confidence interval (CI): 0.657-0.823].
CONCLUSION: Patients with low HGS are prone to increased postoperative complications and delayed postoperative recovery. Postoperative LOI is independently correlated with ASA score ≥ 3, low HGS, and moderate frailty. Therefore, assessment of frailty and HGS prior to radical resection of CRC facilitates preoperative risk stratification.