Papel de los protocolos de recuperación acelerada en la morbimortalidad postoperatoria de pacientes frágiles sometidos a cirugía oncológica colorrectal

Introduction. Colon cancer is one of the most prevalent neoplastic pathologies worldwide. The incidence of this disease increases with age, but chronological age correlates imprecisely with postoperative outcomes, and conventional tools do not adequately measure the patient's functional reserve. This gives rise to the concept of frailty. Objective: The aim was to analyze postoperative outcomes of colorectal cancer surgeries and the impact of applying enhanced recovery protocols (FT) in frail patients. Methods: Patients operated on between 2018 and 2021 were compared for morbidity and mortality between frail and non-frail patients of all ages. Frail patients were defined as those with a “Modified Frailty Index (mFI-5)” >2. Risks of complications, unplanned hospitalizations within 30 days postoperative, and mortality at 30, 90, and 365 days were analyzed. Additionally, a comparison of frail patients was made regarding morbidity and mortality, reoperations, hospitalizations, and hospital days based on their inclusion in FT. Results: A total of 334 patients were included. Frail patients had a higher risk of complications at 30 days (p=0.005), longer hospitalizations (p=0.001), and a greater risk of mortality compared to non-frail patients. Regarding FT, no significant associations were found with the occurrence of complications or mortality in relation to non-frail patients. Conclusions: Frailty is an independent risk factor for postoperative morbidity and mortality in patients of all ages undergoing colorectal cancer surgery. Incorporating these patients into accelerated recovery protocols is safe and reduces hospital stay.