Association of the Flemish Triage Risk Screening Tool with postoperative outcomes in older adults after colorectal cancer surgery: retrospective cohort study.

Authors

Federico Ghignone, Giampaolo Ugolini, Isacco Montroni, Filippo Banchini, Fausto Catena, Davide Cavaliere, Giorgio Ercolani, Gianluca Garulli, Andrea Lucchi, Valentina Danesi, Ilaria Massa, Parisa Soleimani, William Balzi, Alice Andalò, Martina Cavallucci, Nicola Gentili, Andrea Roncadori, ESCA Collaborative Group

Published in

BJS open. Volume 10. Issue 5. Sep 04, 2026.

Abstract

Older adults undergoing colorectal cancer (CRC) surgery are at increased risk of postoperative complications, mortality, and loss of independence. Frailty screening tools may support perioperative risk stratification. This study evaluated the association between the Flemish Triage Risk Screening Tool (fTRST) and postoperative outcomes.
This retrospective multicentre cohort study analysed the Emilia-Romagna Surgical Colorectal Audit. Patients aged ≥ 70 years undergoing CRC surgery (2019-2023) were included. Patients with fTRST scores ≥ 2 and < 2 were matched 1 : 1 using propensity score matching. Primary outcomes were 30-, 90-, and 180-day mortality and complications. Secondary outcomes included prolonged hospital stay and discharge to a non-independent setting. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed.
In all, 1539 patients were included in the study. Mortality at 30, 90, and 180 days was 4.2%, 7.1%, and 10.5%, respectively. In the unmatched cohort, each 1-point increase in fTRST score was significantly associated with 30-day mortality (odds ratio (OR) 1.36; 95% confidence interval (c.i.) 1.12 to 1.66), complications (OR 1.12; 95% c.i. 1.02 to 1.23), prolonged hospital stay (OR 1.13; 95% c.i. 1.03 to 1.24), and discharge to a non-independent setting (OR 1.35; 95% c.i. 1.21 to 1.51). After matching 566 pairs, higher fTRST score remained significantly associated with 30-day mortality (OR 1.33; 95% c.i. 1.09 to 1.63) and discharge to a non-independent setting (OR 1.40; 95% c.i. 1.25 to 1.59). ROC analysis using an fTRST cut-off of ≥2 showed moderate discrimination for 30-day mortality and discharge to a non-independent setting, with areas under the ROC curve of 72.4% (negative predictive value 98.2%) and 67.2% (positive predictive value 66.3%), respectively.
The fTRST is a simple screening tool for identifying older adults at risk of adverse postoperative and functional outcomes after CRC surgery, supporting perioperative planning.

PMID:
42814591
Bibliographic data and abstract were imported from PubMed on 01 Oct 2026.

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