An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery

ÖZDEMİR R., YAMAN F.

Medicina (Lithuania), cilt.61, sa.6, 2025 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 61 Sayı: 6
  • Basım Tarihi: 2025
  • Doi Numarası: 10.3390/medicina61060969
  • Dergi Adı: Medicina (Lithuania)
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals
  • Anahtar Kelimeler: anesthesia recovery, colorectal cancer surgery, frailty, geriatrics, postoperative complications, rectus femoris, sarcopenia, thigh length, ultrasonography, vastus intermedius
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Backgrounds and Objectives: In this study, we aimed to assess preoperative frailty among hospitalized patients over 60 undergoing colorectal cancer surgery. We investigated the impacts of frailty and sarcopenia on postoperative recovery, complications, and discharge time, while also identifying a cost-effective, bedside-accessible USG parameter for diagnosing sarcopenia among patients assessed using the “Sonographic Thigh Adjustment Ratio” method. Materials and Methods: In this prospective study, we investigated the impacts of frailty and sarcopenia on the postoperative outcomes of 42 geriatric patients (with American Society of Anesthesiologists (ASA) scores of I–III) undergoing colorectal cancer surgery under general anesthesia. Frailty was assessed using the FRAIL scale, and sarcopenia was evaluated using the STAR (sonographic thigh adjustment ratio). Ultrasonographic measurements of rectus femoris and vastus intermedius muscle thicknesses were taken, and thigh lengths (TLs) were recorded. Ratios, including rectus femoris thickness/TL (RFT/TL), vastus intermedius thickness/TL (VIT/TL), and total muscle thickness/TL (TMT/TL), were calculated. Postoperative anesthesia recovery was monitored using the Modified Aldrete Score, indicating the time until discharge from the recovery unit. Complications were classified using the Clavien–Dindo system, and hospital discharge times were noted. Results: We observed significant differences between frailty status and ASA scores, as well as between age and frailty status. Muscle thickness significantly differed between the frail and pre-frail patients. Among the sarcopenic patients, age differences were significant. In men, VIT/TL was significantly correlated with sarcopenia diagnosis, whereas, in women, RFT/TL, VIT/TL, and TMT/TL were all correlated with sarcopenia. Conclusions: Based on our results, we conclude that VIT/TL measurement can serve as a predictive marker for preoperative sarcopenia, optimizing patient health before surgery.