96SARCOPENIA, FRAILTY AND NUTRITIONAL STATUS OF COLORECTAL CANCER SURGICAL PATIENTS AND URINARY BIOMARKERS: STUDY PROTOCOL

Abstract

Introduction: Pre-operative frailty in older surgical patients is associated with poorer surgical outcomes, and often co-exists with sarcopenia. Poor nutritional status is also associated with poor peri-operative outcomes, but is difficult to assess due to recall bias and the imprecision of currently available biomarkers. Metabolomics is a technique that quantitatively profiles urinary biomarkers, providing an objective measurement of nutritional status at a certain time point. This prospective cohort study will assess these three factors in isolation and combination. The primary objective of this research is to provide feasibility data to inform a larger study in the future. Method(s): Fifty patients aged 65 or over who are undergoing surgery for colorectal cancer (with curative intent) will be recruited via the Older Persons Surgical Outcomes Collaboration (OPSOC). The three factors will be assessed in the perioperative period using the following methods: * Frailty: 7-point Clinical Frailty Scale (CFS), the Groningen Frailty Indicator (GFI). * Sarcopenia: gait speed assessment, hand grip strength and CT morphometric analysis. * Nutrition status: short-form Mini Nutritional Assessment questionnaire and sequential urine metabolomics assessment. Result(s): Patient groups will be determined based on their frailty (frail or non-frail) and sarcopenia (sarcopenic or not) status. Urinary profiling (using metabolomics) will provide an objective measurement of nutritional status for comparison between the frail and non-frail groups. Descriptive independent samples t-tests and two way repeated measures ANOVA will be used to compare the characteristics between sarcopenia and non-sarcopenic groups. Outcome measures will be length of hospital stay, readmission to hospital within 30 days, post-operative complications (using the Clavien-Dindo classification) and mortality (30-day and 90-day). Conclusion(s): Metabolomic urinary assessment may provide novel biomarkers to determine the impact of surgery on clinical outcomes, and in future may result in prevention of complications with improved patient recovery.