Functional Not Medical Frailty Is Associated With Long-Term Disability After Surgery for Colorectal Cancer

Abstract

BACKGROUND Frailty has been associated with increased morbidity after surgery. However, few studies investigate long-term functional outcomes. METHODS  Patients ≥ 65 years old who underwent surgery for colorectal cancer were surveyed regarding their ability to perform activities of daily living, measured by Barthel Index, before and after surgery. Patients also reported time to return to their functional baseline. RESULTS Pre-operative moderate dependency was associated with declining function at six months (OR: 8.8; CI: 1.8-42.6) and one year post-operatively (OR: 17.5; CI: 2.8-109.8). Pre-operative functional frailty was associated with subjective failure to return to baseline (OR: 4.8 and 4.2) for slightly and moderately dependent patients and a longer time to return to baseline. Medical frailty, based on the modified Frailty Index, was not significantly associated with failure to return to baseline. CONCLUSIONS Measures of functional frailty are better predictors of failure to return to baseline, than measures of medical frailty.