Multidomain physiological vulnerability before gastrointestinal cancer surgery in adults aged 60+
In 450 adults aged 60+ having curative gastrointestinal cancer surgery, a higher baseline Perioperative Aging Burden Index was associated with more delirium, complications, delayed discharge and poorer survival; the index is investigational, not a validated tool. [1]
Automatic summary · not editorially reviewed
The key findings
The prospective cohort enrolled 450 adults aged 60 or older undergoing curative gastrointestinal cancer surgery and followed them for 3 years. [1]
Higher baseline PABI was independently associated with postoperative delirium, complications, delayed discharge and poorer survival. [1]
The authors state PABI should currently be considered an investigational risk phenotype rather than a validated clinical prediction tool. [1]
The source at a glance
- Study type / format
- Prospective cohort study (abstract).
- Population / context
- 450 adults aged 60 or older undergoing curative gastrointestinal cancer surgery.
- Summary based on
- Study abstract
- Original publication
- August 9, 2026
Prospective cohort of 450 older surgical patients
This prospective cohort enrolled 450 adults aged 60 or older undergoing curative gastrointestinal cancer surgery and followed them for 3 years. Before surgery and during postoperative recovery, the team assessed inflammation, nutritional and immune function, sarcopenia-related measures, sleep-circadian and autonomic regulation, psychological vulnerability and cognitive performance. From these they built the Perioperative Aging Burden Index (PABI) using hierarchical principal component analysis. The authors describe PABI as a clinically measurable physiological vulnerability phenotype, not a molecular aging clock.
Supporting source [1]
Higher baseline PABI linked to worse outcomes
Of the 450 enrolled patients, 441 contributed to the baseline PABI. A higher baseline PABI was independently associated with postoperative delirium (adjusted odds ratio 1.88 per 1-standard-deviation increase; 95% CI 1.43-2.47), clinically significant complications (1.55; 1.20-2.00), delayed discharge (adjusted hazard ratio 0.77; 0.66-0.89), poorer disease-free survival (1.42; 1.21-1.67) and poorer overall survival (1.36; 1.13-1.64). Adding PABI to clinicopathologic models raised the optimism-corrected C-index for 3-year disease-free survival from 0.684 to 0.738 after bootstrap validation. These are associations, not proof of cause.
Supporting source [1]
Three recovery patterns; index still investigational
Longitudinal trajectory modeling identified three recovery patterns after surgery: rapid recovery, intermediate recovery and sustained high physiological burden. The authors conclude that PABI should currently be considered an investigational risk phenotype rather than a validated clinical prediction tool. They call for external multicenter validation and future intervention studies to test whether simplified assessments of physiological vulnerability can improve perioperative risk stratification and patient outcomes.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This is a single prospective cohort with internal bootstrap validation only; external multicenter validation is still required, and the associations do not establish causation.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Pan S, Wang G. · europepmc.org · August 9, 2026