Abstract
OBJECTIVE: Complications from surgery as well as the side effects of postoperative chemotherapy, can lead to a decline in the treatment effect of elderly cancer patients, which is closely related to pre-frailty. This study aimed to analyze the prevalence and influencing factors of preoperative pre-frailty in elderly patients with gastric cancer, explore its predictive value, and construct a risk prediction model. METHODS: 317 elderly gastric cancer patients was recruited from the 1(st) Hospital of China Medical University between September 1, 2022, to December 18, 2024. Fried Frailty Phenotype, Health Literacy Scale for Chronic Patients, and Quality of Life Instruments for Gastric Cancer Patients. Logistic regression analysis was employed to identify the influencing factors of pre-frailty. ROC curve was used to evaluate the predictive value of the identified factors, and RStudio software was utilized to construct a Nomogram-based risk prediction model. RESULTS: Among the 317 included patients, 177 (53.4%) were pre-frail. Binary Logistic regression identified age, comorbidity, hemoglobin concentration, malnutrition risk, depression status, and GI symptoms as independent influencing factors (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) was 0.986 [95% CI (0.972, 0.999)]with an optimal cutoff value of 0.452, corresponding to a sensitivity of 0.889 and a specificity of 0.945. CONCLUSION: The prevalence of preoperative pre-frailty is high in elderly patients with gastric cancer. Clinicians should pay attention to elderly, patients with combidity, low hemoglobin, malnutrition risk, poor mental healthy, and obvious gastric cancer-specific symptoms. The constructed risk prediction model demonstrates good predictive accuracy and discriminative ability.