Predictive value of preoperative frailty combined with Controlling Nutritional Status score for postoperative lung infection in breast cancer patients

Breast cancer, the most common malignancy in women, often requires modified radical mastectomy, which can lead to complications like postoperative pulmonary infections. These infections, with an incidence of 11.26 to 20.19%, significantly impact prognosis and mortality. Frailty and nutritional status (Controlling Nutritional Status [CONUT] score) are key predictors of these complications, highlighting the need for their early assessment. This study assesses the predictive value of preoperative frailty combined with the CONUT score for postoperative pulmonary infections in breast cancer patients. Patients who underwent elective modified radical mastectomy for breast cancer at Fuyang Cancer Hospital between January 2022 to February 2024 were included. Frailty and nutritional status were evaluated within 24 hours of admission using the frailty scale and CONUT score, respectively. Multivariable logistic regression was employed to identify independent risk factors for postoperative pulmonary infections. The predictive performance of the combined frailty and CONUT score was assessed using receiver operating characteristic curves and decision curve analysis. A total of 416 patients were analyzed, with 84 exhibiting preoperative frailty and 39 experiencing postoperative pulmonary infections. Preoperative frailty, CONUT score, age, and a history of combined chemoradiotherapy were identified as independent risk factors for postoperative pulmonary infections. The combined assessment of preoperative frailty and CONUT score demonstrated strong predictive value, with an area under the curve of 0.777 (95% confidence interval: 0.700-0.854). The combination of preoperative frailty and the CONUT score is an effective tool for predicting postoperative pulmonary infections in breast cancer patients.