Preoperative reduced hand grip strength and oral frailty as a predictor of disability in the elderly following hepatobiliary-pancreatic surgery

Abstract

Abstract Background This study aimed to investigate the usefulness of preoperative assessment of frailty in elderly patients using a self-check questionnaire and hand grip strength assessment on surgical outcomes and disability after hepatobiliary-pancreatic surgery. Methods We retrospectively analyzed data of 150 elderly patients (≥ 70 years) following hepatobiliary-pancreatic surgery for malignancies between June 2020 and June 2022. Disability was defined as a new need for long-term health care or an increase in the level of care within six months after surgery. We assessed frailty using the frailty checkup introduced by the Ministry of Health, Labor, and Welfare to check the state of frailty. Results The incidence of disability was significantly correlated with reduced grip strength (P = 0.001), difficulty eating hard foods (P = 0.004), and falling (P = 0.049). Multivariate analysis showed that difficulty eating hard foods (P = 0.016), oral frailty, and reduced hand grip strength (P = 0.007) were independent risk factors for the incidence of postoperative disability. Patients at risk of reduced hand grip strength and difficulty eating hard foods showed significantly lower albumin and zinc levels. Furthermore, patients with both risks were significantly associated with increased postoperative complications (P = 0.026), prolonged postoperative hospital stay (P = 0.015), increased hospital transfer (P < .001), and the incidence of disability (P < .001). Conclusion Oral frailty and reduced handgrip strength may be useful screening tools for predicting postoperative disability in patients undergoing hepatobiliary-pancreatic surgery.