Association between preoperative oral frailty and postoperative infectious complications in patients undergoing colorectal cancer surgery: a retrospective analysis using the oral frailty index-8.

PURPOSE: Oral frailty may increase surgical risk; however, its association with postoperative infections in patients with colorectal cancer remains unclear. We evaluated whether preoperative oral frailty, assessed using the Oral Frailty Index-8 (OFI-8), could predict 30-day postoperative infectious complications.

METHODS

We retrospectively reviewed patients who underwent colorectal cancer surgery between April 2022 and December 2024 at our institution. Before surgery, patients completed the OFI-8 and Mini Nutritional Assessment Short-Form, which were verified by the nursing staff. A high oral frailty risk was defined as an OFI-8 score ≥ 4. Clinicopathological variables and infectious complications were compared between the groups. Logistic regression was used to identify the factors associated with complications.

RESULTS

Among the 140 patients, those with OFI-8 ≥ 4 were older and had more polypharmacy, larger tumors, and a poorer renal function. Eighteen patients developed infectious complications. Age ≥ 75 years, rectal cancer, OFI-8 ≥ 4, and pathological T4 stage were identified as predictors of infectious complications. Multivariate analyses confirmed that OFI-8 ≥ 4 and rectal cancer were independent risk factors. Infectious complications were associated with prolonged hospitalization.

CONCLUSION

OFI-8 is a simple outpatient screening tool for identifying patients at high risk of infectious complications following colorectal cancer surgery. Targeted OFI-8-guided perioperative risk interventions may improve the outcomes and reduce the healthcare burden.