• Shogo Tanaka, Masaki Ueno, Hiroya Iida, Masaki Kaibori, Takeo Nomi, Fumitoshi Hirokawa, Hisashi Ikoma, Takuya Nakai, Hidetoshi Eguchi, and Shoji Kubo.
• Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
• J Hepatobiliary Pancreat Sci. 2018 Aug 1; 25 (8): 377-387.

BackgroundAge-related events, such as cardiopulmonary complications, delirium, transfer to a rehabilitation facility, and dependency are a major problem after hepatic resection in the elderly. This prospective multicenter study aimed to preoperatively evaluate frailty in the elderly according to a phenotypic frail index, named the "Kihon Checklist (KCL)," to predict "age-related events" after hepatic resection.MethodsBetween May 2016 and September 2017, 217 independently living patients who consented among all patients aged ≥65 years who planned to undergo hepatic resection were included in the study. Preoperative frailty was defined as a total KCL score ≥8. We analyzed clinical characteristics and outcomes, including age-related events (major respiratory and cardiac complications, delirium medication needed, transfer to rehabilitation facility, and dependency) between patients with and without frailty.ResultsOf the 217 patients, 63 and 154 were classified into the frail and non-frail groups, respectively. The incidences of age-related events (31.7% vs. 7.8%, P < 0.001) were higher in the frail group. Multivariate analysis indicated that frailty (P < 0.001, hazard ratio 5.16) and resection of ≥2 sectors (P = 0.014, hazard ratio 2.98) were independent risk factors for age-related events.ConclusionsFrailty evaluated by KCL in the elderly can predict postoperative age-related events after hepatic resection.© 2018 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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