# Impact of impaired intrinsic capacity on postoperative frailty in elderly patients undergoing colorectal surgery: study protocol for a single-center, prospective, cohort study

## TL;DR

This study investigates how preoperative decline in intrinsic capacity affects postoperative frailty in elderly patients undergoing colorectal surgery.

## Contribution

It introduces a prospective cohort study to explore the link between impaired intrinsic capacity and postoperative frailty in elderly surgical patients.

## Key findings

- Participants will be classified based on preoperative intrinsic capacity scores to assess postoperative frailty risk.
- The study will evaluate multiple outcomes, including pain, recovery quality, and fall risk, to understand frailty progression.
- Results may guide targeted interventions to reduce frailty risk in elderly patients with impaired intrinsic capacity.

## Abstract

Frailty is characterized by a decline in multiple physiological systems, increasing vulnerability to stressors such as surgery and anesthesia. A decline in intrinsic capacity is common among elderly populations and has been demonstrated to be a predictor of frailty in community-dwelling seniors. However, the relationship between preoperative intrinsic capacity decline and postoperative frailty in surgical patients remains unclear.

This study is a single-center, prospective, cohort study. The study will recruit participants aged 60 years and above who are scheduled to undergo elective colorectal surgery. Participants will be classified into an exposed group (intrinsic capacity score ≤ 8) and a non-exposed group (intrinsic capacity score ≥ 9) according to their preoperative intrinsic capacity assessment. The primary outcome is the risk of frailty in elderly patients with impaired intrinsic capacity within one year following colorectal surgery. The secondary outcomes include postoperative pain scores, sleep quality, recovery quality, grip strength, fall risk, activities of daily living, onset time of moderately frailty, incidence of moderately frailty, and adverse events. All assessments will be conducted at predetermined intervals through face-to-face interviews during hospitalization and via telephone follow-up post-discharge.

This study aims to clarify the risk of postoperative frailty in older patients with impaired intrinsic capacity. This study seeks to enable the early identification of patients with impaired intrinsic capacity, allowing for the implementation of targeted interventions to reduce the risk of postoperative frailty.