ConclusionS arcopenia and frailty seem to have significant adverse impacts on the occurrence of postoperative outcomes .
Background Gastric cancer is a major health problem , and frailty and sarcopenia will affect the postoperative outcomes in older people .
However , there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery .
Redefining Geriatric Preoperative Assessment Using Frailty, Disability and Co-Morbidity
Objectives : ( 1 ) Determine the relationship of geriatric assessment markers to 6-month postoperative mortality in elderly patients . ( 2 ) Create a clinical prediction rule using geriatric markers from preoperative assessment . Background : Geriatric surgery patients have unique physiologic vulnerability requiring preoperative assessment beyond the traditional evaluation of older adults . The constellation of frailty , disability and comorbidity predict poor outcomes in elderly hospitalized patients . Methods : Prospect ively , subjects ≥65 years undergoing a major operation requiring postoperative intensive care unit admission were enrolled . Preoperative geriatric assessment s included  : Mini-Cog Test ( cognition ) , albumin , having fallen in the past 6-months , hematocrit , Katz Score ( function ) , and Charlson Index ( comorbidities )  . Outcome measures included 6-month mortality ( primary ) and postdischarge institutionalization ( secondary ) . Results : One hundred ten subjects ( age 74 ± 6 years ) were studied . Six-month mortality was 15 % ( 16/110 ) . Preoperative markers related to 6-month mortality included : impaired cognition ( P < 0.01 ) , recent falls ( P < 0.01 ) , lower albumin ( P < 0.01 ) , greater anemia ( P < 0.01 ) , functional dependence ( P < 0.01 ) , and increased comorbidities ( P < 0.01 ) . Similar statistical relationships were found for all 6 markers and postdischarge institutionalization . Logistic regression identified any functional dependence ( odds ratio 13.9 ) as the strongest predictor of 6-month mortality . Four or more markers in any one patient predicted 6-month mortality with a sensitivity of 81 % ( 13/16 ) and specificity of 86 % ( 81/94 ) . Conclusions : Geriatric assessment markers for frailty , disability and comorbidity predict 6-month postoperative mortality and postdischarge institutionalization . The preoperative presence of ≥4 geriatric-specific markers has high sensitivity and specificity for 6-month mortality . Preoperative assessment using geriatric-specific markers is a substantial paradigm shift from the traditional preoperative evaluation of older adults
ConclusionS arcopenia and frailty seem to have significant adverse impacts on the occurrence of postoperative outcomes .
Background Gastric cancer is a major health problem , and frailty and sarcopenia will affect the postoperative outcomes in older people .
However , there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery .