Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients

Abstract The number of older adults is growing rapidly worldwide, and many surgical diseases are prevalent in this population. Resilience, the ability to adapt positively to adversity, remains a multisystemic process with no standardized objective measurement methods. The aim of this study was to id...

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Main Authors: Jung-Yeon Choi, Yoo-Seok Yoon, Kwang-il Kim, Cheol-Ho Kim
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-82627-w
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author Jung-Yeon Choi
Yoo-Seok Yoon
Kwang-il Kim
Cheol-Ho Kim
author_facet Jung-Yeon Choi
Yoo-Seok Yoon
Kwang-il Kim
Cheol-Ho Kim
author_sort Jung-Yeon Choi
collection DOAJ
description Abstract The number of older adults is growing rapidly worldwide, and many surgical diseases are prevalent in this population. Resilience, the ability to adapt positively to adversity, remains a multisystemic process with no standardized objective measurement methods. The aim of this study was to identify the association between resilience components and frailty, postoperative complications, and quality of life changes after pancreatectomy in older patients. This study evaluated older patients (aged ≥ 65) scheduled for pancreatectomy between August 2020 and December 2023. Patients who underwent a Comprehensive Geriatric Assessment and signed informed consent were included. Frailty was determined by multidimensional frailty score more than 5. Neurohumoral resilience was measured using the ACTH stimulation test, cardiovascular autonomic function using orthostatic blood pressure measurement, and cognitive-motor function using dual-task gait tests. The primary outcome was postoperative complications, and the secondary outcome was the deterioration in quality of life one year after pancreatectomy. A total of 57 patients were included in the analysis. Among them, 17 (29.8%) were classified as frail, 10 patients (17.5%) experienced postoperative complications, and 12 patients (24.5%) had worsened quality of life after one year. Low blood pressure and slow usual gait speed was associated with frailty. Diminished cortisol responsiveness correlated with frailty and postoperative complications. Quality of life deterioration was associated with differences between dual-task (serial 7) gait speed and fast gait speed. This study highlights the potential association between multidomain resilience components, frailty, and clinical outcomes in older patients undergoing pancreatectomy. Future research should focus on developing robust, objective, and reliable resilience metrics for clinical use.
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spelling doaj-art-ebf354e7beb74f48a6d1868ae3fd18d62025-08-20T03:07:40ZengNature PortfolioScientific Reports2045-23222025-04-011511710.1038/s41598-024-82627-wMultiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patientsJung-Yeon Choi0Yoo-Seok Yoon1Kwang-il Kim2Cheol-Ho Kim3Department of Internal Medicine, Seoul National University Bundang HospitalDepartment of Surgery, Seoul National University Bundang HospitalDepartment of Internal Medicine, Seoul National University Bundang HospitalDepartment of Internal Medicine, Seoul National University Bundang HospitalAbstract The number of older adults is growing rapidly worldwide, and many surgical diseases are prevalent in this population. Resilience, the ability to adapt positively to adversity, remains a multisystemic process with no standardized objective measurement methods. The aim of this study was to identify the association between resilience components and frailty, postoperative complications, and quality of life changes after pancreatectomy in older patients. This study evaluated older patients (aged ≥ 65) scheduled for pancreatectomy between August 2020 and December 2023. Patients who underwent a Comprehensive Geriatric Assessment and signed informed consent were included. Frailty was determined by multidimensional frailty score more than 5. Neurohumoral resilience was measured using the ACTH stimulation test, cardiovascular autonomic function using orthostatic blood pressure measurement, and cognitive-motor function using dual-task gait tests. The primary outcome was postoperative complications, and the secondary outcome was the deterioration in quality of life one year after pancreatectomy. A total of 57 patients were included in the analysis. Among them, 17 (29.8%) were classified as frail, 10 patients (17.5%) experienced postoperative complications, and 12 patients (24.5%) had worsened quality of life after one year. Low blood pressure and slow usual gait speed was associated with frailty. Diminished cortisol responsiveness correlated with frailty and postoperative complications. Quality of life deterioration was associated with differences between dual-task (serial 7) gait speed and fast gait speed. This study highlights the potential association between multidomain resilience components, frailty, and clinical outcomes in older patients undergoing pancreatectomy. Future research should focus on developing robust, objective, and reliable resilience metrics for clinical use.https://doi.org/10.1038/s41598-024-82627-wFrailtyResiliencePostoperative complicationsQuality of lifePancreatectomy
spellingShingle Jung-Yeon Choi
Yoo-Seok Yoon
Kwang-il Kim
Cheol-Ho Kim
Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients
Scientific Reports
Frailty
Resilience
Postoperative complications
Quality of life
Pancreatectomy
title Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients
title_full Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients
title_fullStr Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients
title_full_unstemmed Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients
title_short Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients
title_sort multiple domain resilience components and frailty postoperative complications and one year quality of life deterioration after pancreatectomy in older patients
topic Frailty
Resilience
Postoperative complications
Quality of life
Pancreatectomy
url https://doi.org/10.1038/s41598-024-82627-w
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AT kwangilkim multipledomainresiliencecomponentsandfrailtypostoperativecomplicationsandoneyearqualityoflifedeteriorationafterpancreatectomyinolderpatients
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