Effect of geriatric interventions on postoperative outcomes in frail older patients undergoing elective gastrectomy for gastric cancer.

INTRODUCTION

Postoperative complications are common after gastrectomy for gastric cancer, particularly in older patients with increased frailty. This study evaluates the impact of targeted geriatric interventions on postoperative outcomes in frail older patients undergoing gastrectomy.

MATERIALS AND METHODS

A total of 120 frail patients aged 65 years and older were enrolled in a before-and-after study design. Participants were divided into a standard care group (n = 52) and an intervention group (n = 68) of comparable characteristics. All participants underwent a comprehensive geriatric assessment (CGA) before surgery to identify frailty. The intervention group received targeted geriatric interventions consisting of nutritional support, comorbidity management, and physical therapy in addition to standard care. Postoperative outcomes, including length of hospital stay (LOS), intensive care unit (ICU) admission rates, and postoperative complications were compared between the groups.

RESULTS

The intervention group demonstrated significantly lower rates of ICU admissions (11.8% vs. 34.6%, p = 0.003), emergency room visits (2.1% vs. 42.3%, p = 0.02), and 30-day readmissions (14.7% vs. 32.7%, p = 0.02) compared to the standard care group. The median LOS was comparable between the groups (18 days vs. 19 days, p = 0.73). While overall complication rates (10.3% vs. 21.2%, p = 0.10) and 30-, 90-, and 180-day postoperative mortality rates were numerically lower in the intervention group, these differences were not statistically significant.

DISCUSSION

Targeted geriatric interventions during the perioperative period significantly reduced ICU admissions, emergency room visits, and hospital readmissions among frail older patients undergoing gastrectomy for gastric cancer. These findings support the routine integration of geriatric care strategies to improve postoperative recovery and reduce adverse outcomes in older surgical patients.