Preoperative frailty and postoperative health outcomes in postmenopausal patients undergoing gynecological cancer surgery: a retrospective observational study

Purpose: This study aimed to assess preoperative frailty using the Frailty Index–Laboratory (FI-LAB) in postmenopausal patients undergoing gynecological cancer surgery and to investigate the association between frailty level and postoperative health outcomes.Methods: A retrospective review was conducted of medical records from 198 postmenopausal women who underwent gynecologic cancer surgery at G Hospital between January 2018 and December 2024. Frailty was evaluated using the FI-LAB, and postoperative outcomes included recovery room stay, hospital stay, transfusion, and complications. Data were analyzed using analysis of variance and the chi-square test.Results: Higher frailty levels were associated with older age (p = .030), cancer type (p < .001) and stage (p = .001), American Society of Anesthesiologists Physical Status Classification class (p = .036), and longer anesthesia (p = .023) and surgery time (p = .026). Among health outcomes, patients with higher frailty scores had longer hospital stays (F = 4.26, p = .015) and higher transfusion rates (χ2 = 11.78, p = .005).Conclusion: Preoperative frailty assessed by FI-LAB may serve as a useful predictor of postoperative outcomes in patients undergoing gynecologic cancer surgery. Early identification of frailty could enable targeted perioperative interventions to improve recovery and support the integration of frailty screening into routine preoperative evaluation.