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NCT Number: NCT07440095

Mortality Predictors in Patients 80+ After Major Abdominal Surgery: Role of Frailty and Physiological Reserve

The aim of this study is to identify independent risk factors for 30-day mortality in patients aged 80 and over who have undergone major abdominal surgery. While traditional risk scoring systems often focus on chronic disease burden, they may not fully capture the biological decline associated with aging. This research specifically focuses on the predictive value of "frailty" and "physiological reserve" in determining surgical outcomes for this "old-old" patient population.

In this retrospective cohort study, data from approximately 200 patients treated between 2022 and 2025 will be analyzed. Frailty will be assessed using the Modified Frailty Index (mFI-5), and physiological reserve will be evaluated through preoperative laboratory markers such as albumin, creatinine, and lymphocyte counts. By determining how these factors influence postoperative mortality, the study aims to improve preoperative patient selection, enhance risk communication with families, and provide a basis for protective strategies like prehabilitation.

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Key information

Conditions

Frailty Abdomen Cancer Aged, 80 and Over Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications

Age range

80 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Rea

Ankara, Yenimahalle, 06200, Turkey (Türkiye)

About this study

As the global population ages, the "old-old" (aged 80 and over) patient group is increasingly encountered in surgical clinics. Major abdominal surgery in this demographic is categorized as high-risk due to both the severity of surgical trauma and the presence of multiple comorbidities. Traditional risk assessment tools often emphasize chronic disease burden but may fail to reflect the loss of biological resilience inherent in aging. "Frailty" has emerged as a critical parameter in predicting surgical outcomes, representing a state of reduced physiological reserve and increased vulnerability to stressors, independent of chronological age.

This retrospective study is designed to investigate the independent predictors of 30-day mortality in patients aged 80 and older who underwent major abdominal surgery (including gynecologic oncology, surgical oncology, and urologic oncology procedures) at Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital.

Methodology and Data Collection:

Patient data from the years 2022, 2023, 2024, and 2025 will be extracted from the hospital's electronic database. The study will include approximately 200 patients who meet the inclusion criteria.

Frailty Assessment: The Modified Frailty Index (mFI-5) will be utilized to evaluate the frailty status of each patient. This index is a validated tool for retrospective studies and includes parameters such as functional status and history of specific comorbidities.

Physiological Reserve: This will be assessed using objective preoperative clinical and laboratory parameters, including serum albumin levels, creatinine, leukocyte/lymphocyte ratios, hemoglobin levels, and the American Society of Anesthesiologists (ASA) physical status score.

Outcome Measure: The primary endpoint is 30-day postoperative mortality. If 30-day follow-up data is not available in the hospital records, patients or their relatives will be contacted via telephone to determine the survival status.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients aged 80 years and older
  • Underwent major abdominal surgery between January 2022 and December 2025
  • Availability of at least 30 days of postoperative follow-up data
  • Complete medical records available in the hospital information system

Exclusion criteria

  • Patients under 80 years of age
  • Underwent surgical procedures other than major abdominal surgery
  • Missing or incomplete follow-up data within the first 30 days postoperatively
  • Insufficient data for the assessment of frailty (mFI-5) or physiological reserve parameters (e.g., missing preoperative laboratory values)

Treatment and study plan

Major Abdominal Surgery and Frailty Assessment

Other

Retrospective evaluation of patients aged 80 and over who underwent major abdominal surgery (including surgical oncology, gynecologic oncology, and urologic oncology). The study involves the assessment of preoperative frailty using the Modified Frailty Index (mFI-5) and the analysis of physiological reserve through laboratory markers (albumin, creatinine, lymphocyte count, hemoglobin). The primary focus is to determine the impact of these factors on 30-day postoperative mortality.

Primary outcomes

  1. 30-Day Postoperative Mortality

    Time frame: From the date of surgery up to 30 days postoperatively

    The occurrence of death from any cause within 30 days following the major abdominal surgical procedure. This will be assessed using hospital electronic records and, if necessary, through telephone follow-ups with patients or their relatives.

Secondary outcomes

  1. Modified Frailty Index (mFI-5) Score

    Time frame: Preoperative assessment (retrospective data from 2022-2025)

    Assessment of patients' frailty status using the Modified Frailty Index (mFI-5). The mFI-5 consists of 5 items: history of hypertension, diabetes mellitus, congestive heart failure, chronic obstructive pulmonary disease, and functional status. Each item is assigned 1 point if present. The total score ranges from 0 to 5, where 0 represents "not frail" and 5 represents "severely frail." Higher scores indicate a higher degree of frailty and a worse clinical outcome

  2. Preoperative Serum Albumin Level

    Time frame: Preoperative laboratory values collected retrospectively from 2022-2025.

    Evaluation of preoperative serum albumin levels (measured in g/dL) as an indicator of nutritional status and physiological reserve.

  3. Preoperative Serum Creatinine Level

    Time frame: Preoperative laboratory values collected retrospectively from 2022-2025.

    Evaluation of preoperative serum creatinine levels (measured in mg/dL) to assess renal function as part of the physiological reserve

  4. Preoperative Hemoglobin Level

    Time frame: Preoperative laboratory values collected retrospectively from 2022-2025

    Evaluation of preoperative hemoglobin levels (measured in g/dL) to assess the oxygen-carrying capacity and physiological reserve.

Sponsors and collaborators

Lead sponsor

Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Other

Registry information

Official study title

Mortality Predictors After Major Abdominal Surgery in Patients Aged 80 and Over: The Role of Frailty and Physiological Reserve

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Feb 27, 2026
Registry last updated
Apr 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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