Study on the relationship between postoperative frailty and postoperative recovery quality in elderly patients with gastrointestinal tumor

[Objective] To explore the relationship between postoperative frailty and postoperative recovery quality in elderly patients with gastrointestinal tumor, and to analyze the chain mediating effects of sleep disorders and depression on postoperative frailty and postoperative recovery quality. [Methods] 375 elderly patients with gastrointestinal tumor who underwent surgical treatment in the First Affiliated Hospital of Anhui Medical University from November 2021 to June 2022 as the study objects. The general information questionnaire, the Chinese Tilburg frailty scale, 9-item quality of recovery score scale, sleep dysfunction rating scale, and 15-item geriatric depression scale were used for questionnaire investigation. Single factor and multiple linear regression were used to analyze the influencing factors of postoperative recovery quality. SPSS and Bootstrap method were used to construct and verify the chain mediation model. [Results] Multiple linear regression analysis showed that postoperative frailty, sleep disorder and depression were independent factors affecting postoperative recovery quality in elderly patients with gastrointestinal tumors(P<0.001). The incidence of postoperative frailty, sleep disorder and depression were 58.7%, 30.9% and 10.4%, respectively. Postoperative frailty was negatively correlated with postoperative recovery quality (r=-0.752, P<0.001), and was positively correlated with sleep disorders and depression (r=0.571, 0.692, P<0.001). Sleep disorders was positively correlated with depression (r=0.556, P<0.001). Sleep disorders and depression were negatively correlated with postoperative recovery quality (r=-0.563, -0.634, P<0.001). The intermediary model showed that postoperative frailty directly negatively predicted postoperative recovery quality in elderly patients with gastrointestinal tumor (β=-0.567, P<0.001), and the direct effect accounted for 61.63% of the total effect. The mediating effects of sleep disorders, depression and sleep disorders to depression were significant (β=-0.145, -0.166, -0.042, P<0.001), accounting for 15.76%, 18.04% and 4.57% of the total effect respectively. [Conclusion] Postoperative frailty in elderly patients with gastrointestinal tumor has a direct predictive effect on postoperative recovery quality, and is mediated by sleep disorders and depression.