Preoperative social frailty and short-term postoperative outcomes in gastrointestinal cancer surgery: a multicentre prospective cohort study in China.

Wei Wang, Yun Ye, Huipin Zhang, Xindong Shen

Abstract readMulticenter StudyObservational Study

In one paragraph

Observational study in World journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Wei WangDepartment of Gastrointestinal Surgery, The First People's Hospital of Changzhou and the 3rd Affiliated Hospital of Soochow University, Changzhou, China.ORCID http://orcid.org/0009-0005-7979-1021

Yun YeDepartment of Nursing, The First People's Hospital of Changzhou and the 3rd Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, 213000, Jiangsu, China.

Huipin ZhangDepartment of Nursing, The First People's Hospital of Changzhou and the 3rd Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, 213000, Jiangsu, China. 921152503@qq.com.ORCID http://orcid.org/0000-0001-7504-6079

Xindong ShenDepartment of Operating Room, The First People's Hospital of Changzhou and the 3rd Affiliated Hospital of Soochow University, Changzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSocial frailty, characterised by insufficient social support, is a significant concern that can adversely affect patients' health. This study aimed to investigate the impact of preoperative social frailty on short-term outcomes in patients with gastrointestinal cancer.

methodsThis multicentre prospective cohort study was conducted in three tertiary hospitals in Jiangsu Province, China (August 2021-February 2025). Patients were categorized into a non-social frailty group (score = 0) and a social frailty group (score ≥ 1) using the Help, Participation, Loneliness, Financial, Talk (HALFT) scale. We performed 1:1 nearest-neighbour propensity score matching to balance covariates including sex, age, residence, marital status, and the tumour node metastasis (TNM) stage, and assessed balance using standardised mean differences (SMD), with an absolute SMD <0.1 considered acceptable. The primary outcomes were overall postoperative complications (Clavien-Dindo grade ≥ II) and major postoperative complications (Clavien-Dindo grade ≥ III). Secondary outcomes included ICU admission, hospitalisation expenses, total hospitalisation duration, and 30- and 90-day mortality. The primary and secondary outcome measures in both groups after PSM were analysed using the chi-squared test (or Fisher's exact test) and Mann-Whitney U test. To quantify the associations, binary logistic regression was further performed for the primary measures.

resultsAfter PSM, 133 matched pairs were generated, and covariates were well balanced (all |SMD| < 0.1). The social frailty group had a higher rate of overall complications (OR = 2.378; 95% CI 1.342-4.211; P = 0.003). Major complications did not differ significantly between groups (OR = 1.842, 95% CI 0.780-4.349, P = 0.163). The social frailty group also had higher ICU admission (8.3% vs. 2.3%; P = 0.028), greater hospitalisation expenses (61,354 vs. 56,525 RMB; P < 0.001), and longer total hospitalisation duration (17.0 vs. 15.0 days; P = 0.001). There was no statistically significant difference in 30- or 90-day mortality between the groups (3.0% vs. 0%; P = 0.122).

conclusionPreoperative social frailty was associated with higher risks of overall postoperative complications, ICU admission, increased hospitalisation expenses, and longer total hospitalisation duration compared with non-frail patients.

Indexed as

Digestive System Surgical ProceduresFrailtyGastrointestinal NeoplasmsPostoperative ComplicationsSocial SupportAgedChinaFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesGastrointestinal cancerOverall complicationsPrognosisPropensity score matchingSocial frailty

Identifiers

PMID41588535

DOI10.1186/s12957-026-04211-y

PMCPMC12918011

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.