World J Surg Oncol. 2026 Jan 26. doi: 10.1186/s12957-026-04211-y. Online ahead of print.
ABSTRACT
OBJECTIVE: Social 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.
METHODS: This 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.
RESULTS: After 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).
CONCLUSION: Preoperative 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.
PMID:41588535 | DOI:10.1186/s12957-026-04211-y
