Frailty was independently associated with prolonged length of stay >10 days after elective abdominal surgery (adjusted OR 3.12; 95% CI 1.72-5.67).
Cohort (n=223)
Yes
Does physiological reserve phenotyping combining frailty and muscle strength predict prolonged length of stay in adults undergoing elective abdominal surgery?
Integrating frailty and muscle strength into physiological reserve phenotypes better predicts postoperative length of stay than chronological age in patients undergoing abdominal surgery.
Odds Ratio: 3.12 (95% CI 1.72–5.67)
Background: Chronological age inadequately captures biological vulnerability among surgical patients. Frailty and muscle strength reflect physiological reserve, yet their combined contribution to postoperative length of stay (LOS) remains insufficiently explored. Methods: We conducted a prospective multicenter observational cohort study including 223 adults undergoing elective abdominal surgery. Frailty was assessed using the Fried phenotype, and admission handgrip strength (HGS) was measured with a calibrated dynamometer. Prolonged LOS was defined as >10 days (75th percentile) and also analyzed continuously using ln(LOS + 1). Multivariable logistic and linear regression models adjusted for age, sex, frailty status, and surgical indication. Patients were additionally stratified into four physiological reserve phenotypes combining frailty and HGS. Results: LOS ranged from 0 to 68 days; a total of 48 patients (21.6%) experienced prolonged hospitalization. In multivariable logistic regression, frailty (adjusted OR 3.12, 95% CI 1.72–5.67) and oncologic surgery (adjusted OR 7.63, 95% CI 3.12–18.65) were independently associated with prolonged LOS, whereas chronological age was not. Female sex was associated with lower odds of prolonged LOS (adjusted OR 0.39, 95% CI 0.18–0.87). Similar associations were observed when LOS was analyzed continuously. Physiological reserve phenotyping revealed graded LOS distributions: Fit–Strong patients had the shortest stays (mean 5.5 ± 4.3 days), while Frail–Weak patients experienced the longest and most variable hospitalization. Conclusions: Postoperative LOS clusters according to multidimensional physiological reserve rather than chronological age. Integrating frailty and muscle strength identifies clinically meaningful phenotypes that may improve perioperative risk stratification beyond age-based approaches and inform personalized perioperative planning, resource allocation, and patient-centered decision-making across heterogeneous surgical populations in worldwide settings.
Cudnik et al. (Wed,) conducted a cohort in elective abdominal surgery (n=223). Frailty was evaluated on Prolonged length of stay (>10 days) (OR 3.12, 95% CI 1.72-5.67). Frailty was independently associated with prolonged length of stay >10 days after elective abdominal surgery (adjusted OR 3.12; 95% CI 1.72-5.67).