Abstract
BACKGROUND: Older adults with gastric cancer are at high risk of postoperative complications, partly owing to age-related physical function decline. The Short Physical Performance Battery (SPPB) is widely used to assess physical function in older adults; however, its association with postoperative complications following gastrectomy remains unclear. AIM: To investigate the association between SPPB and postoperative complications in older adults who underwent gastrectomy. METHODS: This retrospective cohort study included patients aged ≥ 75 years who underwent elective gastrectomy for gastric cancer between July 2021 and December 2023. Preoperative physical function was assessed using the SPPB, grip strength, and frailty status. Patients were divided into high (SPPB ≥ 10) and low-SPPB (SPPB ≤ 9) groups. The primary outcome was postoperative complications (Clavien-Dindo Grade ≥ II) within 30 days post-surgery. Multivariate logistic regression was performed to identify factors associated with postoperative complications. RESULTS: Among 156 patients included, postoperative complications occurred in 21.2% of patients. The low-SPPB group had significantly higher complication rates than the high-SPPB group. Multivariate analysis revealed that a low SPPB score was independently associated with postoperative complications (odds ratio: 2.83, 95% confidence interval: 1.02–7.83, p = 0.045). DISCUSSION: Grip strength, frailty, and nutritional status showed no significant associations. The low-SPPB group demonstrated significantly worse outcomes in balance, walking speed, chair stand, and higher frailty prevalence. Preoperative physical function was significantly associated with postoperative complications in older adults who undergo gastrectomy. CONCLUSIONS: The SPPB may help identify high-risk patients and guide preoperative interventions to improve physical function and reduce postoperative complications.