The Effect of Frailty and Sarcopenia on Perioperative Complications in Patients Over 65 Years Undergoing Elective Surgery, Prospective-Observational Study

Introduction: With aging of population, frailty and sarcopenia have become very important issues. Therefore, we aimed to evaluate patients for frailty and sarcopenia preoperatively who aged 65≤ underwent elective surgical operation in university hospital and search complications intraoperatively and postoperatively. Materials and Method: This prospective, cross-sectional study performed between November 2021 and May 2022 at university hospital and patients aged 65 years and older underwent elective surgery included. Patients scored with frailty index. Both thickness and cross-sectional area of rectus femoris muscle were measured by ultrasound for evaluating sarcopenia in all patients, preoperatively. Anesthetic management, surgical risks were determined. Intraoperative and postoperative complications recorded. Results: Totally 1112 patients were assessed and 279 patients were included. According to the cross-sectional area 35.5%; according to rectus femoris thickness 32.2% and according to both of them 25.4% were detected as sarcopenia. While fragility was detected in 151(54.7%) patients which 112(74.2%) pre-frail, 39(25.8%) fragile. 176(63.8%) patients experienced intraoperative complications. Postoperative complications were detected in 115(41.7%). The sarcopenia, frailty, and higher surgical risk classifications are increased intraoperative and postoperative complications (4.7, 4.1, 4 and 3.7, 6.4, 3.9 fold, respectively). Length of stay hospital (6.5 and 5 days) and intensive care unit (21 and 19 days), intraoperative (91.4% and 100%) and postoperative complication (81.4% and 87.2%) was higher sarcopenia and frailty (p<0.001). Conclusion: Intraoperative and postoperative complications were observed higher in frail and sarcopenic patients. Evaluation of frailty and sarcopenia in over 65 years at preoperative period can be helpful for prediction to risk of intraoperative and postoperative complications. Keywords: Intraoperative Complications; Frailty; Mortality; Postoperative Complications; Sarcopenia.