Preoperative physiological reserve surrogate markers predict short-term adverse postoperative outcomes in cancer patients: a cross-sectional study

Preoperative physiological reserve surrogate markers predict short-term adverse postoperative outcomes in cancer patients: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Preoperative physiological reserve surrogate markers predict short-term adverse postoperative outcomes in cancer patients: a cross-sectional study Clara Gentil-Daher, Carolina Castro, João Antunes, Pedro Martins, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6901133/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose To mitigate surgery-related morbidity and mortality and elevate the standard of care for surgical patients, clinicians must leverage precise pre-operative risk assessment tools. This study aimed to investigate the predictive value of surrogate markers for preoperative physiological reserve in relation to postoperative outcomes. Methods We analyzed data from 125 patients undergoing elective surgery for gastric or head and neck cancer (December 2018 to June 2019), using binary logistic regression models, adjusted for confounders. Outcomes of interest were: postoperative complications, major complications, need for intermediate care unit, prolonged length of stay (> 10 days), 30-days readmission, 30-days reintervention and postoperative burden (patients who had ≥ 1 adverse postoperative outcome, among those mentioned above). Results Low physical activity (OR, 2.34; [95% CI, 1.03–5.35], p = 0.043) and frailty (OR, 5.73; [95% CI, 1.79–18.34], p = 0.003) increased the probability of intermediate care unit admission. Frailty predicted postoperative burden (OR, 4.58; [95% CI, 1.60-13.08], p = 0.004). Low gait speed raised the likelihood of reintervention within 30 days (OR, 5.22; [95% CI, 1.23–22.19], p = 0.025). Probable sarcopenia heightened the odds of prolonged hospitalization (OR, 3.18; [95% CI, 1.15–8.81], p = 0.026). Conclusion Low physical activity, low gait speed, probable sarcopenia and frailty are independent predictors of short-term adverse postoperative outcomes. The identified predictors emphasize the need for an integrated approach to patient care, incorporating prehabilitation strategies tailored to individual risk profiles. cancer patients pre-operative risk assessment physiological reserve surgical oncology postoperative outcomes Figures Figure 1 1. INTRODUCTION Surgery is one of the main pillars of oncological treatment, often representing the best chance of cure for cancer patients. By 2030, it is estimated that 45 million surgical procedures will be required annually worldwide [ 1 ]. However, despite global efforts to improve perioperative care, postoperative morbidity and mortality remain significant [ 2 ]. Identifying patients at higher risk of adverse postoperative outcomes is crucial, particularly as those with reduced physical fitness and physiological reserve are most vulnerable [ 3 ]. Physiological reserve defines the body’s capacity to withstand and recover from physiological stressors, making it a critical determinant of resilience and recovery in the context of surgery [ 4 ]. It is influenced by intrinsic changes in organs and systems, all of which tend to decline with aging, chronic diseases, or sedentary lifestyles [ 5 ]. While cardiopulmonary exercise testing (CPET) is the gold standard for the assessment of physiological reserve, its use is often impractical due to high resource requirements and time limitations. Surrogate markers have been proposed as practical tools to surpass those limitations and to assess preoperative risk [ 6 ]. These include measures of physical activity, handgrip strength, mobility, and frailty status, which have all been associated with postoperative outcomes in prior studies [ 7 – 10 ]. For instance, Dronkers et al. [ 11 ] identified physical activity as the most robust predictor of postoperative recovery in patients undergoing major abdominal oncologic surgery. However, the study only included patients aged 59 years and older, limiting the generalizability of the findings to broader age groups. Furthermore, a systematic review and meta-analysis by Jiang et al. [ 12 ] demonstrated that low preoperative handgrip strength was associated with a higher risk of total complications, pneumonia, ileus, and short-term mortality in patients with gastrointestinal cancer. Similarly, a systematic review and meta-analysis by Ding et al. [ 13 ] pointed out that frailty was related to an increased risk of severe postoperative complications, 30-day mortality, and 5-year mortality in patients with digestive system cancer. However, studies evaluating patients with head and neck cancer, who have a high risk of malnutrition and a significant number of comorbidities, are limited. Furthermore, most studies assess physiological reserve through isolated markers rather than a multidimensional approach that allows direct comparisons of their predictive value. Addressing these limitations may improve understanding of physiological reserve in the context of surgical oncology, improving risk stratification and guiding more effective prehabilitation strategies. To address these gaps, this cross-sectional observational study aimed to evaluate the predictive value of multiple preoperative surrogate markers of physiological reserve in relation to short-term postoperative outcomes in oncological patients. By integrating a broader range of markers, this study seeks to provide a more comprehensive understanding of how physiological reserve influences surgical risk. The findings are expected to inform strategies for risk stratification and optimization in the preoperative period, including prehabilitation programs designed to enhance patients’ functional capacity and recovery. Such efforts are critical to reducing surgery-related morbidity and mortality, ultimately improving the standard of care for cancer patients. 2. METHODS 2.2 Study Design And Patients A cross-sectional study was conducted on consecutive patients diagnosed with gastric or head and neck cancer who were eligible for major elective surgery at the Portuguese Oncology Institute of Porto (IPO-Porto) during the period of December 2018 to June 2019. Data was collected in all the patients fulfilling the inclusion criteria and that agreed to be a part of the study. Inclusion criteria for patients was to be over 18 years old, to be diagnosed with cancer that required surgical treatment and to be able to answer the questionnaires in Portuguese or English. Any patients not meeting the inclusion criteria were excluded from the study. All clinical data such as age, sex, body mass index (BMI), comorbidities, Charlson Comorbidity Index (CCI), Malnutrition Universal Screening Tool (MUST) score, treatment, tumor stage, tumor type, physical fitness, and postoperative outcomes were prospectively collected from the patient’s medical record. This work has been approved by the ethical committee of the IPO-Porto (CES-IPOP 03). This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cross-sectional studies [ 14 ]. 2.3 Measures 2.3.1 Surrogate markers for preoperative physiological reserve Physical activity level. Daily physical activity was assessed using the International Physical Activity Questionnaire – Short Form (IPAQ-SF) [ 12 ], which includes questions on three activity types: vigorous (e.g., heavy lifting, digging, aerobics), moderate (e.g., carrying light loads, cycling at a regular pace), and walking (e.g., at work or home) [ 15 ]. Activity scores were calculated based on duration (minutes) and frequency (days/week), and patients were initially classified into three groups according to established algorithms [ 16 ]. For analytical purposes, participants were grouped as low vs. moderate/high physical activity. Probable sarcopenia. Handgrip strength (HGS) was measured using a dynamometer (T.K.K.5401; Takei Scientific Instruments, Tokyo, Japan). Patients performed three maximal voluntary contractions with their dominant hand, seated with elbow at 90°, resting on a chair arm. The mean of three attempts was recorded. Probable sarcopenia was defined using EWGSOP2 cut-off points: <27 kg for men and < 16 kg for women [ 17 ]. This variable was dichotomized as “yes” or “no.” Mobility. Mobility was assessed via gait speed, measured over a 5 m walk at usual pace. Patients were categorized as having gait speed 5% body weight in the past year), exhaustion (based on two CES-D scale items), low physical activity (< 383 kcal/week for men; <270 kcal/week for women), weakness (HGS below sex- and BMI-specific thresholds), and slowness (gait speed below sex- and height-specific cut-offs). HGS was assessed as described above. Patients were classified as frail (≥ 3 criteria), pre-frail (1–2), or robust (0). 2.3.2 Outcomes Postoperative outcomes were monitored for 30 days following surgery. In cases of discharge, electronic health records were reviewed to identify readmissions due to surgical complications. Postoperative complications (POCs) were classified according to the Clavien–Dindo (CD) system [ 19 ], ranging from minor deviations (grade I) to death (grade V). Morbidity was categorized as minor (CD grades I–II) or major (CD ≥ III), and further dichotomized as “no/minor” vs. “major” complications. ICU admission was defined as postoperative transfer to the intermediate care unit and categorized as “yes” or “no.” Length of stay (LOS) was defined as the number of days from surgery to hospital discharge and was categorized as ≤ 10 or > 10 days (prolonged LOS), based on the sample median. Readmission was defined as any hospital readmission within 30 days post-discharge. Reintervention referred to any additional surgical procedure required postoperatively. A composite variable, postoperative burden, was created to indicate patients with at least one adverse postoperative outcome, categorized as “yes” or “no.” 2.3.3 Covariates Patient characteristics were extracted from medical records and dichotomized as follows: age (< 65 vs. ≥65 years), sex (female vs. male), unintentional weight loss (no vs. yes), BMI (< 30 vs. ≥30 kg/m²), number of comorbidities (< 3 vs. ≥3; sample median), CCI (< 5 vs. ≥5; sample median), MUST score (low vs. medium/high), neoadjuvant therapy (no vs. yes), tumor stage (I–II vs. III–IV), and tumor type (first diagnosis vs. local recurrence/metastasis). 2.4 Statistical Analysis Descriptive data were presented as absolute numbers and percentages for categorical variables. For continuous variables, distributions were assessed, and results were expressed as mean ± standard deviation (SD) or median and interquartile range (IQR), as appropriate. Associations between patient characteristics or physiological reserve markers and postoperative outcomes were evaluated using the chi-square test (if all cell counts > 5) or Fisher’s exact test (if any cell count ≤ 5). Relative risk (RR) with 95% confidence intervals (CI) was calculated. Physiological reserve markers with p ≤ 0.05 in the bivariate analysis were included in binary logistic regression models, adjusted for confounding variables (p < 0.20 in bivariate analysis), to assess their prognostic value for adverse postoperative outcomes. Missing data were handled using the multiple imputation command in the statistical software. The significance level was set at two-sided p < 0.05. Analyses were performed using SPSS version 29.0 (IBM Corp., Armonk, NY, USA). 3. RESULTS 3.1 Patient Characteristics The final cohort included 125 patients, with a mean age of 62.1 ± 11.2 years. Most were male (74.4%) and under 65 years old (60.8%) (Table 1 ). Overall, 52.8% reported unintentional weight loss in the past year, 19.2% were classified as obese, 6.5% were at high risk of malnutrition according to the MUST, and 60% had a CCI ≥ 5 (Table 1 ). Slightly more than half (54.4%) had head and neck cancer. Most had stage I (27.2%) or IV disease (28.8%) (Table 1 ). Only 14.4% underwent neoadjuvant chemotherapy and/or radiotherapy. Regarding tumor type, 62.4% had a primary tumor, 24% had local recurrence, and 13.6% had metastatic tumors. Most surgeries (48%) lasted between 120 and 239 minutes (Table 1 ). Table 1 Demographic and clinical characteristics of patients who underwent gastric and head and neck cancer surgery ( n = 125) Variable Total ( n = 125) Age (years) 62.1 ± 11.2 Age (categorized) < 65 years 76 (60.8) ≥ 65 years 49 (39.2) Sex Male 93 (74.4) Female 32 (25.6) Tumor site Gastric 57 (45.6) Head and neck 68 (54.4) Marital status Single 8 (6.4) Married 90 (72.0) Divorced 14 (11.2) Widower 12 (9.6) Other 1 (0.8) Education level No qualifications 5 (4.1) Primary school 63 (51.6) Basic education 36 (29.5) High school 10 (8.2) University education 8 (6.6) Weight loss (kilograms) 2.0 [0.0; 6.0] Weight loss (categorized) No 59 (47.2) Yes 66 (52.8) BMI (kg/m²) 25.7 [22.6; 28.8] BMI (categorized) < 30 kg/m² 101 (80.8) ≥ 30 kg/m² 24 (19.2) Comorbidities No 11 (8.8) 1 21 (16.8) 2 21 (16.8) 3 or more 72 (57.6) Comorbidities (categorized) < 3 53 (42.4) ≥ 3 72 (57.6) CCI 5.0 [4.0; 7.0] CCI (categorized) < 5 50 (40.0) ≥ 5 75 (60.0) MUST score Low 97 (78.9) Medium 18 (14.6) High 8 (6.5) Neoadjuvant therapy No 107 (85.6) Yes 18 (14.4) Tumor stage I 34 (27.2) II 21 (16.8) III 28 (22.4) IV 36 (28.8) Unknown 6 (4.8) Tumor type First cancer 78 (62.4) Local recurrence 30 (24.0) Metastasis 17 (13.6) Time from diagnosis to surgery (days) 62.0 [45.0; 93.5] Duration of surgery (minutes) 140.0 [102.0; 210.0] Duration of surgery (categorized) < 120 minutes 43 (34.4) 120–239 minutes 60 (48.0) ≥ 240 minutes 22 (17.6) Physical activity levels Low 63 (50.4) Moderate 40 (32.0) High 22 (17.6) Gait speed (meters/seconds) 1.3 ± 0.4 Gait speed (categorized) < 0.8 meters/seconds 16 (12.8) ≥ 0.8 meters/seconds 109 (87.2) Handgrip strength (kilograms) 30.8 ± 8.6 Probable sarcopenia No 99 (79.2) Yes 26 (20.8) Frailty phenotype Robust 30 (24.0) Prefrail 69 (55.2) Frail 26 (20.8) POCs No 80 (64.0) Yes 45 (36.0) Minor 29 (64.4) Major 16 (35.6) ICU admission No 67 (53.6) Yes 58 (46.4) LOS ≤ 10 days 69 (55.2) > 10 days 56 (44.8) 30-days readmission No 96 (76.8) Yes 29 (23.2) 30-days reintervention No 106 (84.8) Yes 19 (15.2) Postoperative burden No 50 (40.0) Yes 75 (60.0) a Abbreviation: BMI, body mass index; CCI, charlson comorbidity index; ICU, intermediate care unit; LOS, length of stay; MUST, malnutrition universal screening tool; POCs, postoperative complications b For categories, N (%) is given, for continues variables, mean (SD) or median [1st-3th quartile] were given were appropriate 3.2 Surrogate Markers For Preoperative Physiological Reserve Based on patient-reported data, 50.4% of participants exhibited low levels of physical activity, 32.0% reported moderate levels, and 17.6% reported high levels (Table 1 ). The average gait speed was 1.3 ± 0.4 m/s, with 12.8% showing low mobility (< 0.8 m/s). Mean HGS was 30.8 ± 8.6 kg, with 20.8% classified as having probable sarcopenia. Additionally, 24% were robust, 55.2% pre-frail, and 20.8% frail (Table 1 ). 3.3 Postoperative Outcomes Overall, 36% of patients experienced postoperative complications, 35.6% of which were classified as major (Table 1 ). Nearly half required ICU admission (46.4%), and 44.8% had a length of stay (LOS) longer than 10 days. Additionally, 23.2% were readmitted, 15.2% required reintervention within 30 days of discharge, and 60% experienced a composite postoperative burden (Table 1 ). 3.4 Patient Characteristics and Postoperative Outcomes Bivariate analysis was performed to assess associations between baseline clinical and demographic characteristics and postoperative outcomes, with relative risks calculated (Table 2 ). POCs were significantly associated with stage III–IV tumors (RR: 2.05; 95% CI: 1.20–3.51; p = 0.005). ICU admission was associated with male sex (RR: 2.98; 95% CI: 1.42–6.27; p 10 days was associated with stage III–IV tumors (RR: 1.77; 95% CI: 1.15–2.72; p = 0.006), and 30-day readmission with local recurrence or metastasis (RR: 2.04; 95% CI: 1.08–3.86; p = 0.031). Composite postoperative burden was associated with male sex (RR: 1.81; 95% CI: 1.13–2.89; p = 0.003) and stage III–IV tumors (RR: 1.43; 95% CI: 1.05–1.96; p = 0.018). No significant associations were found between 30-day reintervention and baseline characteristics. Variables with p < 0.20 in the bivariate analysis were included as covariates in the logistic regression models. Table 2 Demographic and clinical characteristics of patients who underwent gastric and head and neck cancer surgery and associations with postoperative outcomes ( n = 125) Characteristics POCs Major complications (CD ≥ III) ICU admission LOS (> 10 days) 30-days readmission 30-days reintervention Postoperative burden n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value Age (categorized) 0.127 0.690 0.855 0.716 0.665 0.453 0.881 < 65 years 23 (51.1) 1 9 (11.8) 1 36 (62.1) 1 33 (58.9) 1 19 (65.5) 1 10 (52.6) 1 46 (61.3) 1 ≥ 65 years 22 (48.9) 1.48 (0.94–2.35) 7 (14.3) 1.21 (0.48–3.03) 22 (37.9) 0.95 (0.64–1.40) 23 (41.1) 1.08 (0.73–1.60) 10 (34.5) 0.82 (0.42–1.61) 9 (47.4) 1.40 (0.61–3.19) 29 (38.7) 0.98 (0.73–1.31) Sex 0.533 0.579 < 0.001 0.169 0.629 0.153 0.003 Female 10 (22.2) 1 5 (15.6) 1 6 (10.3) 1 11 (19.6) 1 6 (20.7) 1 2 (10.5) 1 12 (16) 1 Male 35 (77.8) 1.20 (0.68–2.14) 11 (11.8) 0.76 (0.28–2.01) 52 (89.7) 2.98 (1.42–6.27) 45 (80.4) 1.41 (0.83–2.37) 23 (79.3) 1.32 (0.59–2.95) 17 (89.5) 2.92 (0.71–11.97) 63 (84) 1.81 (1.13–2.89) Weight loss (categorized) 0.114 0.171 0.116 0.110 0.770 0.607 0.108 No 17 (37.8) 1 5 (8.5) 1 23 (39.7) 1 22 (39.3) 1 13 (44.8) 1 10 (52.6) 1 31 (41.3) 1 Yes 28 (62.2) 1.47 (0.90–2.40) 11 (16.7) 1.97 (0.73–5.33) 35 (60.3) 1.36 (0.92–2.01) 34 (60.7) 1.38 (0.92–2.07) 16 (55.2) 1.10 (0.58–2.09) 9 (47.4) 0.80 (0.35–1.84) 44 (58.7) 1.27 (0.94–1.71) BMI (categorized) 0.865 0.190 0.153 0.910 0.591 1.000 0.853 < 30 kg/m² 36 (80.0) 1 11 (10.9) 1 50 (86.2) 1 45 (80.4) 1 25 (86.2) 1 16 (84.2) 1 61 (81.3) 1 ≥ 30 kg/m² 9 (20.0) 1.05 (0.59–1.88) 5 (20.8) 1.91 (0.73–4.99) 8 (13.8) 0.67 (0.37–1.23) 11 (19.6) 1.03 (0.63–1.67) 4 (13.8) 0.67 (0.26–1.75) 3 (15.8) 0.79 (0.25–2.49) 14 (18.7) 0.97 (0.67–1.40) Comorbidities (categorized) 0.124 0.422 0.347 0.173 0.763 0.594 0.301 < 3 15 (33.3) 1 5 (31.3) 1 22 (37.9) 1 20 (35.7) 1 13 (44.8) 1 7 (36.8) 1 29 (38.7) 1 ≥ 3 30 (66.7) 1.47 (0.89–2.45) 11 (68.8) 1.62 (0.60–4.38) 36 (62.1) 1.20 (0.81–1.79) 36 (64.3) 1.33 (0.87–2.01) 16 (55.2) 0.91 (0.48–1.72) 12 (63.2) 1.26 (0.53–2.99) 46 (61.3) 1.17 (0.86–1.58) CCI (categorized) 0.704 0.444 0.241 0.607 0.545 0.760 0.264 < 5 17 (37.8) 1 5 (10.0) 1 20 (34.5) 1 21 (37.5) 1 13 (44.8) 1 7 (36.8) 1 27 (36.0) 1 ≥ 5 28 (62.2) 1.10 (0.68–1.78) 11 (14.7) 1.47 (0.54–3.97) 38 (65.5) 1.27 (0.84–1.90) 35 (62.5) 1.11 (0.74–1.67) 16 (55.2) 0.82 (0.43–1.55) 12 (63.2) 1.14 (0.48–2.70) 48 (64.0) 1.19 (0.87–1.61) MUST score 0.359 0.744 0.187 0.052 0.119 1.000 0.109 Low 33 (73.3) 1 12 (12.4) 1 41 (73.2) 1 39 (70.9) 1 19 (67.9) 1 14 (77.8) 1 54 (72.0) 1 Medium and High 12 (26.7) 1.36 (0.82–2.23) 4 (15.4) 1.24 (0.44–3.54) 15 (26.8) 1.36 (0.91–2.04) 16 (29.1) 1.53 (1.04–2.26) 9 (32.1) 1.77 (0.91–3.43) 4 (22.2) 1.07 (0.38–2.97) 19 (25.3) 1.31 (0.98–1.76) Neoadjuvant therapy 1.000 0.196 0.309 1.000 0.070 0.072 0.349 No 39 (86.7) 1 12 (11.2) 1 52 (89.7) 1 48 (85.7) 1 28 (96.6) 1 19 (100.0) 1 66 (88.0) 1 Yes 6 (13.3) 0.91 (0.45–1.84) 4 (22.2) 1.98 (0.72–5.47) 6 (10.3) 0.69 (0.35–1.36) 8 (14.3) 0.99 (0.57–1.73) 1 (3.4) 0.21 (0.03–1.46) 0 (0.0) - 9 (12) 0.81 (0.50–1.32) Tumor stage 0.005 0.605 0.065 0.006 0.199 1.000 0.018 I-II 13 (29.5) 1 6 (10.9) 1 20 (36.4) 1 18 (32.7) 1 10 (34.5) 1 9 (47.4) 1 27 (37.5) 1 III-IV 31 (70.5) 2.05 (1.20–3.51) 9 (14.1) 1.29 (0.49–3.39) 35 (63.6) 1.50 (0.99–2.28) 37 (67.3) 1.77 (1.15–2.72) 19 (65.5) 1.63 (0.83–3.21) 10 (52.6) 0.95 (0.42–2.18) 45 (62.5) 1.43 (1.05–1.96) Tumor type 0.337 0.574 0.065 0.066 0.031 0.070 0.497 First cancer 31 (68.9) 1 11 (14.1) 1 31 (53.4) 1 40 (71.4) 1 13 (44.8) 1 8 (42.1) 1 45 (60.0) 1 Local recurrence and metastasis 14 (31.1) 0.75 (0.45–1.26) 5 (10.6) 0.75 (0.28–2.04) 27 (46.6) 1.45 (1.00-2.09) 16 (28.6) 0.66 (0.42–1.04) 16 (55.2) 2.04 (1.08–3.86) 11 (57.9) 2.28 (0.99–5.26) 30 (40.0) 1.11 (0.83–1.47) a Abbreviation: BMI, body mass index; CCI, charlson comorbidity index; CD, clavien-dindo; ICU, intermediate care unit; LOS, length of stay; MUST, malnutrition universal screening tool; POCs, postoperative complications; RR, relative risk b p -value obtained by the Chi-square test or Fisher’s exact test c Bold = statistically significant, p ≤ 0.05 3.5 Surrogate Markers For Preoperative Physiological Reserve And Postoperative Outcomes Bivariate analysis was conducted to assess the association between surrogate markers of preoperative physiological reserve and postoperative outcomes, with relative risks (RRs) calculated (Table 3 ). Patients with low physical activity had a 1.61-fold higher risk of ICU admission compared to those with moderate/high activity (95% CI: 1.08–2.40; p = 0.015). Low gait speed (< 0.8 m/s) was associated with a 2.17-fold higher risk of 30-day readmission (95% CI: 1.11–4.23; p = 0.037) and showed a trend toward increased risk of 30-day reintervention (RR: 2.43; 95% CI: 1.01–5.84; p = 0.055). Patients with probable sarcopenia had increased risk of POCs (RR: 1.72; 95% CI: 1.09–2.72; p = 0.033), ICU admission (RR: 1.58; 95% CI: 1.10–2.27; p = 0.029), prolonged LOS (RR: 1.66; 95% CI: 1.14–2.41; p = 0.018), and composite postoperative burden (RR: 1.38; 95% CI: 1.05–1.82; p = 0.048). Frailty (pre-frail + frail) was associated with increased risk of ICU admission (RR: 2.30; 95% CI: 1.17–4.52; p = 0.004) and postoperative burden (RR: 1.84; 95% CI: 1.12–3.00; p = 0.003), compared to robust patients. Binary logistic regression analyses were performed to evaluate the predictive power of markers significantly associated (p < 0.05) with any postoperative outcome in the bivariate analysis (Table 3 ), as shown in Fig. 1 and detailed in the Supplementary Table 1 . Models were adjusted for confounders identified from baseline characteristics with p < 0.20 in Table 2 . Low physical activity remained a significant predictor of ICU admission after adjustment (OR: 2.34; 95% CI: 1.03–5.35; p = 0.043). Low gait speed predicted 30-day readmission (OR: 3.08; 95% CI: 1.03–9.17; p = 0.044), but this association lost significance after adjustment. However, it remained a significant predictor of 30-day reintervention (OR: 5.22; 95% CI: 1.23–22.19; p = 0.025). Probable sarcopenia predicted the occurrence of POCs (OR: 2.56; 95% CI: 1.06–6.17; p = 0.036) and ICU admission (OR: 2.67; 95% CI: 1.08–6.58; p = 0.033), though these associations lost significance after adjustment. Nonetheless, it remained an independent predictor of prolonged LOS (OR: 3.18; 95% CI: 1.15–8.81; p = 0.026). Finally, frailty (pre-frail + frail) independently predicted ICU admission (OR: 5.73; 95% CI: 1.79–18.34; p = 0.003) and composite postoperative burden (OR: 4.58; 95% CI: 1.60–13.08; p = 0.004), even after adjustment for confounders. Table 3 Surrogate markers for preoperative physiological reserve of patients who underwent gastric and head and neck cancer surgery and associations with postoperative outcomes ( n = 125) Characteristics POCs Major complications (CD ≥ III) ICU admission LOS (> 10 days) 30-days readmission 30-days reintervention Postoperative burden n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value n (%) RR (95% CI) p value Physical activity levels 0.710 0.569 0.015 0.591 0.398 0.808 0.058 High and moderate 21 (46.7) 1 9 (56.3) 1 22 (37.9) 1 26 (46.4) 1 12 (41.4) 1 10 (52.6) 1 32 (42.7) 1 Low 24 (53.3) 1.12 (0.70–1.80) 7 (43.8) 0.77 (0.30–1.93) 36 (62.1) 1.61 (1.08–2.40) 30 (53.6) 1.14 (0.77–1.68) 17 (58.6) 1.39 (0.73–2.67) 9 (47.4) 0.89 (0.39–2.03) 43 (57.3) 1.32 (0.99–1.77) Gait speed (categorized) 0.267 0.431 0.432 0.421 0.037 0.055 0.275 ≥ 0.8 m/s 37 (82.2) 1 13 (81.3) 1 49 (84.5) 1 47 (83.9) 1 22 (75.9) 1 14 (73.7) 1 63 (84.0) 1 < 0.8 m/s 8 (17.8) 1.47 (0.85–2.57) 3 (18.8) 1.57 (0.50–4.92) 9 (15.5) 1.25 (0.77–2.02) 9 (16.1) 1.30 (0.80–2.11) 7 (24.1) 2.17 (1.11–4.23) 5 (26.3) 2.43 (1.01–5.84) 12 (16.0) 1.30 (0.94–1.80) Probable sarcopenia 0.033 0.742 0.029 0.018 0.190 0.072 0.048 No 31 (68.9) 1 12 (75.0) 1 41 (70.7) 1 39 (69.6) 1 20 (69.0) 1 12 (63.2) 1 55 (73.3) 1 Yes 14 (31.1) 1.72 (1.09–2.72) 4 (25.0) 1.27 (0.45–3.61) 17 (29.3) 1.58 (1.10–2.27) 17 (30.4) 1.66 (1.14–2.41) 9 (31.0) 1.71 (0.89–3.31) 7 (36.8) 2.22 (0.97–5.07) 20 (26.7) 1.38 (1.05–1.82) Frailty phenotype 0.278 1.000 0.004 0.091 0.080 0.241 0.003 Robust 8 (17.8) 1 4 (25.0) 1 7 (12.1) 1 9 (16.1) 1 3 (10.3) 1 2 (10.5) 1 11 (14.7) 1 Prefrail and frail 37 (82.2) 1.46 (0.77–2.78) 12 (75.0) 0.95 (0.33–2.72) 51 (87.9) 2.30 (1.17–4.52) 47 (83.9) 1.65 (0.92–2.95) 26 (89.7) 2.74 (0.89–8.41) 17 (89.5) 2.68 (0.66–10.96) 64 (85.3) 1.84 (1.12-3.00) a Abbreviation: CD, clavien-dindo; ICU, intermediate care unit; LOS, length of stay; POCs, postoperative complications; RR, relative risk b p -value obtained by the Chi-square test or Fisher’s exact test c Bold = statistically significant, p ≤ 0.05 4. DISCUSSION This study evaluated the predictive value of surrogate markers of preoperative physiological reserve for short-term postoperative outcomes in cancer patients. The findings indicate that low physical activity, frailty, low gait speed, and probable sarcopenia are significant and independent predictors of adverse postoperative outcomes. These results highlight the clinical utility of assessing physiological reserve to identify high-risk patients and guide tailored preoperative interventions. The postoperative morbidity rate observed in this study (36%) is consistent with previously reported rates for gastric and head and neck cancer surgeries, which range between 23% and 37%, depending on surgical complexity and patient ‘characteristics [20–22]. These findings reinforce the importance of employing preoperative screening tools to predict short-term postoperative risks. Identifying modifiable preoperative risk factors is crucial, as targeted interventions such as prehabilitation may help mitigate surgical risks and improve patient outcomes. Low levels of physical activity are associated with reduced functional capacity, lower cardiovascular and muscular endurance, and impaired recovery potential, necessitating additional postoperative care [7, 23]. In our study, low physical activity was identified as an independent predictor of ICU admission, emphasizing its pivotal role in surgical resilience. This finding suggests that incorporating preoperative assessments with practical tools such as the IPAQ can enhance the prediction of postoperative care needs and optimize resource allocation. Supporting this, Toriumi et al. [24] also applied the IPAQ in patients undergoing gastrectomy and found that low physical activity levels were independently associated with a higher incidence of POCs. However, their analysis excluded CD grade 1 complications, considering only those classified as grade 2 or higher as clinically significant. Additionally, compared to our study, the sample analyzed by Toriumi et al. [24] had a higher proportion of patients aged ≥ 65 years. Similarly, a systematic review and meta-analysis by Steffen et al. [7], which included 13 studies, demonstrated that higher preoperative physical activity levels were significantly associated with shorter LOS and improved postoperative quality of life in cancer surgery patients. However, this meta-analysis did not find a significant association between preoperative physical activity and POCs. The authors attributed this discrepancy to the heterogeneity in physical activity measurement methods and outcome definitions across studies. In our study, reduced gait speed was an independent predictor of reintervention within 30 days, likely due to its well-established role as an indicator of overall functional status and frailty. Slow gait speed reflects compromised physical function and muscle strength, which may hinder postoperative recovery and increase the likelihood of reintervention [25, 26]. Prior research has also identified an association between reduced gait speed and adverse postoperative outcomes. For instance, Chandoo et al. [27] found that a walking speed below 0.8 m/s was an independent predictor of postoperative medical complications in elderly patients undergoing curative gastrectomy. Similarly, Karlsson et al. [28] demonstrated that better preoperative physical performance, including higher gait speed, was associated with lower rates of severe postoperative complications and a reduced likelihood of discharge to healthcare facilities in elderly patients undergoing abdominal cancer surgery. Notably, both studies focused exclusively on elderly patients, whereas our sample had a mean age of 62.1 ± 11.2 years, with 60.8% of patients aged < 65 years. This suggests that the predictive value of low gait speed for complications may also extend to younger cancer patient. Probable sarcopenia was a significant predictor of POCs and ICU admission; however, these associations lost statistical significance after adjusting for confounding variables. This may be due to the small sample size, which affects the precision of odds ratio estimates. Nevertheless, our study found that probable sarcopenia was an independent predictor of prolonged LOS. Kuwada et al. [29] similarly reported that gastric cancer patients with sarcopenia, as defined by sex-specific quartile-based cut-off values of the skeletal muscle area to body surface area index measured on preoperative computed tomography scans at the L3 level, had significantly longer hospital stays compared to non-sarcopenic patients. Despite its clinical relevance, sarcopenia remains underdiagnosed and undertreated, likely due to the complexity of its assessment [30]. Few studies have investigated whether probable sarcopenia can serve as a predictor of surgical outcomes in cancer patients. However, existing evidence suggests that probable sarcopenia is an independent predictor of postoperative pneumonia in esophageal cancer patients [31] and a predictor of 12-month mortality in older cancer patients undergoing treatment [32]. Given its ease of assessment through a simple and rapid HGS test, probable sarcopenia screening may be valuable in identifying high-risk surgical patients and guiding prehabilitation strategies. In our study, frailty, as assessed by the Fried Frailty Phenotype, was a robust independent predictor of both postoperative burden (composite outcome) and ICU admission. Frail patients have lower physiological reserve, which may lead to prolonged and complicated recovery, necessitating intensive postoperative care. Supporting this, Ding et al. [33] conducted an observational study with 406 elderly patients undergoing gastric cancer surgery and found that preoperative frailty, assessed using the frailty phenotype, was associated with total complications, prolonged LOS, and 90-day hospital readmission. Similarly, Panayi et al. [34] performed a systematic review and meta-analysis of 16 studies in various surgical populations and concluded that frailty, assessed using the modified frailty index (mFI), is a prognostic indicator that increases the risk of postoperative morbidity and mortality. Another systematic review and meta-analysis [35] demonstrated that preoperative frailty, assessed using validated tools, including clinical scales and laboratory markers, was associated with an increased risk of both total and major POCs in patients with digestive system tumors. Methodological differences, including variations in frailty classification, discrepancies in postoperative outcome definitions, and the relatively small sample size of our study, may have contributed to differences in findings compared to previous studies. The results of our study underscore the importance of assessing preoperative physiological reserve using surrogate markers to anticipate postoperative outcomes. Screening for conditions such as low physical activity, frailty, reduced gait speed, and probable sarcopenia is essential to identify high-risk patients and guide tailored preoperative interventions (e.g. prehabilitation programs), which should be systematically incorporated into surgical care pathways [36]. A recent systematic review and meta-analysis [37] demonstrated that prehabilitation can reduce POCs and decrease LOS in frail patients undergoing colorectal cancer surgery. Therefore, healthcare professionals can use this information to tailor preoperative interventions and postoperative care plans, ultimately improving patient outcomes. This study contributes to the growing body of evidence supporting the evaluation of physiological reserve as a strategy to optimize surgical outcomes. 4.1 Limitations This study's strength lies in its comprehensive evaluation of multiple markers of physiological reserve and their independent associations with postoperative outcomes. However, we acknowledge that the generalization of these results may be limited due to the retrospective design and potential selection bias. Additionally, the single-center design may limit the extrapolation of results to a broader population. Nonetheless, the findings of this study emphasize the importance of comprehensive preoperative evaluation in identifying at-risk patients and implementing preoperative optimization strategies, such as prehabilitation. These findings contribute to advancing standard care for patients undergoing oncologic surgery and underscore the need for future prospective research to validate and expand upon these findings. 5. CONCLUSION Our study highlights the pivotal role of preoperative physiological markers in anticipating and managing short-term adverse postoperative outcomes. The identified predictors emphasize the need for an integrated approach to patient care, incorporating prehabilitation strategies tailored to individual risk profiles. Future prospective studies and interventions informed by these findings may further refine preoperative care paradigms, ultimately improving outcomes and quality of life for this patient population. Declarations Funding This research was supported by the Portuguese Foundation of Science and Technology (FCT) (PROTECT project (grant PTDC/SAU-DES/7945/2020; 10.54499/PTDC/SAU-DES/7945/2020). The Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), part of the Laboratory for Integrative and Translational Research in Population Health (ITR), are funded by FCT (grants UIDB/00617/2020 https://doi.org/10.54499/UIDB/00617/2020; UIDP/00617/2020 https://doi.org/10.54499/UIDP/00617/2020 and LA/P/0064/2020, respectively). Clara Gentil-Daher, Carolina Castro and João Antunes are supported by an individual grant from FCT (10.54499/UI/BD/150674/2020; 2022.13379.BD; SFRH/BD/147776/2019, respectively). Competing interests The authors have no relevant financial or non-financial interests to disclose. CRediT authorship contribution statement CGD: Conceptualization, Funding acquisition, Methodology, Data curation, Investigation, Formal Analysis, Writing – original draft, Writing – review & editing, Visualization. CC: Data curation, Investigation. JA : Data curation, Investigation. PM : Data curation, Investigation. LLS : Project administration, Resources, Supervision. DMG : Conceptualization, Funding acquisition, Methodology, Writing – review & editing, Project administration, Resources, Supervision. All authors read and approved the final manuscrip. Ethics approval This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Portuguese Oncology Institute of Porto (CES-IPOP 03). Consent to participate Informed consent was obtained from all individual participants included in the study. 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Annals of surgical treatment and research , 104 (6), 313–324. https://doi.org/10.4174/astr.2023.104.6.313 Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6901133","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":494556173,"identity":"c18f3e06-2ca3-4203-a762-372932c19a04","order_by":0,"name":"Clara Gentil-Daher","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYDACdhDBxpAAoj58ALHZCWlhRmhhnDkDxGYmRctsHrgIHsDfzPzsw48yuzx+6cMHm21+bZPnY2Zg/PAxB7cWicNsxjN7ziUXS/alJTbn9t02bGNmYJacuQ23FgNmBmMG3jbmxA1neMwf5/bcZgRqYWPmxauF/TPj37b6xP1n+D82W/bctidCC48xM2/b4cQNPDyMzQw/bicS1CJxmKeYWebc8cQZZ9gMG3sbbie3MTM24/ULf3v7ZsY3ZdWJ/T3MDxt+/LltO7+9+eCHj3i0oALGNjDZQKx6EPhDiuJRMApGwSgYKQAA4QJM4z6i5LkAAAAASUVORK5CYII=","orcid":"","institution":"Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) \u0026 RISE@CI-IPOP (Health Research Network)","correspondingAuthor":true,"prefix":"","firstName":"Clara","middleName":"","lastName":"Gentil-Daher","suffix":""},{"id":494556174,"identity":"54d051f1-b690-4ab6-8391-38bcdabae830","order_by":1,"name":"Carolina Castro","email":"","orcid":"","institution":"Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) \u0026 RISE@CI-IPOP (Health Research Network)","correspondingAuthor":false,"prefix":"","firstName":"Carolina","middleName":"","lastName":"Castro","suffix":""},{"id":494556175,"identity":"2424f75f-eee2-4a0f-979c-3ab46edacfac","order_by":2,"name":"João Antunes","email":"","orcid":"","institution":"Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) \u0026 RISE@CI-IPOP (Health Research Network)","correspondingAuthor":false,"prefix":"","firstName":"João","middleName":"","lastName":"Antunes","suffix":""},{"id":494556176,"identity":"dfcf2fc7-46e6-400e-80d7-959f37386f6e","order_by":3,"name":"Pedro Martins","email":"","orcid":"","institution":"Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) \u0026 RISE@CI-IPOP (Health Research Network)","correspondingAuthor":false,"prefix":"","firstName":"Pedro","middleName":"","lastName":"Martins","suffix":""},{"id":494556177,"identity":"35dda054-6c1d-4723-a48f-8364e667e61f","order_by":4,"name":"Lúcio Lara-Santos","email":"","orcid":"","institution":"Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) \u0026 RISE@CI-IPOP (Health Research Network)","correspondingAuthor":false,"prefix":"","firstName":"Lúcio","middleName":"","lastName":"Lara-Santos","suffix":""},{"id":494556179,"identity":"2b34cd00-1d0c-4644-a779-4df200d4e619","order_by":5,"name":"Daniel Moreira-Gonçalves","email":"","orcid":"","institution":"Faculty of Sport, University of Porto","correspondingAuthor":false,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Moreira-Gonçalves","suffix":""}],"badges":[],"createdAt":"2025-06-16 03:23:05","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6901133/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6901133/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":88310975,"identity":"380efb4f-2be5-4aa8-98e4-5a54d6c999d3","added_by":"auto","created_at":"2025-08-05 06:54:42","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":60800,"visible":true,"origin":"","legend":"\u003cp\u003eBinary logistic regression analysis of surrogate markers for preoperative physiological reserve as predictors of adverse postoperative outcomes in patients with gastric and head and neck cancer (n = 125)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAbbreviations:\u003c/em\u003e ICU, intermediate care unit; OR, odds ratio; CI, confidence interval\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAdjustments for covariates:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(a) Adjusted for age (categorized), weight loss (categorized), comorbidities (categorized), and tumor stage\u003c/p\u003e\n\u003cp\u003e(b) Adjusted for sex, weight loss (categorized), BMI (categorized), MUST score, tumor stage, and tumor type\u003c/p\u003e\n\u003cp\u003e(c) Adjusted for sex, weight loss (categorized), MUST score, tumor stage, and tumor type\u003c/p\u003e\n\u003cp\u003e(d) Adjusted for MUST score, neoadjuvant therapy, tumor stage, and tumor type\u003c/p\u003e\n\u003cp\u003e(e) Adjusted for sex, neoadjuvant therapy, and tumor type\u003c/p\u003e\n\u003cp\u003e(f) Adjusted for sex, weight loss (categorized), MUST score, and tumor stage\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6901133/v1/60d8517e377692e1d32e56a2.jpg"},{"id":98426814,"identity":"661e2a6b-111d-4c7b-90b6-46f22a4e87d9","added_by":"auto","created_at":"2025-12-17 16:38:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1792590,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6901133/v1/3723cf09-8595-439d-86d2-92705a704ec9.pdf"},{"id":88310976,"identity":"86a01518-10eb-4299-b8e5-3f866e9cf18d","added_by":"auto","created_at":"2025-08-05 06:54:42","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":22480,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-6901133/v1/0283060db92f2f7fce971bff.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Preoperative physiological reserve surrogate markers predict short-term adverse postoperative outcomes in cancer patients: a cross-sectional study","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eSurgery is one of the main pillars of oncological treatment, often representing the best chance of cure for cancer patients. By 2030, it is estimated that 45\u0026nbsp;million surgical procedures will be required annually worldwide [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. However, despite global efforts to improve perioperative care, postoperative morbidity and mortality remain significant [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Identifying patients at higher risk of adverse postoperative outcomes is crucial, particularly as those with reduced physical fitness and physiological reserve are most vulnerable [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePhysiological reserve defines the body\u0026rsquo;s capacity to withstand and recover from physiological stressors, making it a critical determinant of resilience and recovery in the context of surgery [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. It is influenced by intrinsic changes in organs and systems, all of which tend to decline with aging, chronic diseases, or sedentary lifestyles [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. While cardiopulmonary exercise testing (CPET) is the gold standard for the assessment of physiological reserve, its use is often impractical due to high resource requirements and time limitations. Surrogate markers have been proposed as practical tools to surpass those limitations and to assess preoperative risk [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. These include measures of physical activity, handgrip strength, mobility, and frailty status, which have all been associated with postoperative outcomes in prior studies [\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. For instance, Dronkers et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] identified physical activity as the most robust predictor of postoperative recovery in patients undergoing major abdominal oncologic surgery. However, the study only included patients aged 59 years and older, limiting the generalizability of the findings to broader age groups. Furthermore, a systematic review and meta-analysis by Jiang et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] demonstrated that low preoperative handgrip strength was associated with a higher risk of total complications, pneumonia, ileus, and short-term mortality in patients with gastrointestinal cancer. Similarly, a systematic review and meta-analysis by Ding et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] pointed out that frailty was related to an increased risk of severe postoperative complications, 30-day mortality, and 5-year mortality in patients with digestive system cancer. However, studies evaluating patients with head and neck cancer, who have a high risk of malnutrition and a significant number of comorbidities, are limited. Furthermore, most studies assess physiological reserve through isolated markers rather than a multidimensional approach that allows direct comparisons of their predictive value. Addressing these limitations may improve understanding of physiological reserve in the context of surgical oncology, improving risk stratification and guiding more effective prehabilitation strategies.\u003c/p\u003e\u003cp\u003eTo address these gaps, this cross-sectional observational study aimed to evaluate the predictive value of multiple preoperative surrogate markers of physiological reserve in relation to short-term postoperative outcomes in oncological patients. By integrating a broader range of markers, this study seeks to provide a more comprehensive understanding of how physiological reserve influences surgical risk. The findings are expected to inform strategies for risk stratification and optimization in the preoperative period, including prehabilitation programs designed to enhance patients\u0026rsquo; functional capacity and recovery. Such efforts are critical to reducing surgery-related morbidity and mortality, ultimately improving the standard of care for cancer patients.\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Study Design And Patients\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted on consecutive patients diagnosed with gastric or head and neck cancer who were eligible for major elective surgery at the Portuguese Oncology Institute of Porto (IPO-Porto) during the period of December 2018 to June 2019. Data was collected in all the patients fulfilling the inclusion criteria and that agreed to be a part of the study. Inclusion criteria for patients was to be over 18 years old, to be diagnosed with cancer that required surgical treatment and to be able to answer the questionnaires in Portuguese or English. Any patients not meeting the inclusion criteria were excluded from the study. All clinical data such as age, sex, body mass index (BMI), comorbidities, Charlson Comorbidity Index (CCI), Malnutrition Universal Screening Tool (MUST) score, treatment, tumor stage, tumor type, physical fitness, and postoperative outcomes were prospectively collected from the patient\u0026rsquo;s medical record. This work has been approved by the ethical committee of the IPO-Porto (CES-IPOP 03). This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cross-sectional studies [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Measures\u003c/h2\u003e\u003cdiv id=\"Sec5\" class=\"Section3\"\u003e\u003ch2\u003e2.3.1 Surrogate markers for preoperative physiological reserve\u003c/h2\u003e\u003cp\u003e\u003cem\u003ePhysical activity level.\u003c/em\u003e Daily physical activity was assessed using the International Physical Activity Questionnaire \u0026ndash; Short Form (IPAQ-SF) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], which includes questions on three activity types: vigorous (e.g., heavy lifting, digging, aerobics), moderate (e.g., carrying light loads, cycling at a regular pace), and walking (e.g., at work or home) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Activity scores were calculated based on duration (minutes) and frequency (days/week), and patients were initially classified into three groups according to established algorithms [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. For analytical purposes, participants were grouped as low vs. moderate/high physical activity.\u003c/p\u003e\u003cp\u003e\u003cem\u003eProbable sarcopenia.\u003c/em\u003e Handgrip strength (HGS) was measured using a dynamometer (T.K.K.5401; Takei Scientific Instruments, Tokyo, Japan). Patients performed three maximal voluntary contractions with their dominant hand, seated with elbow at 90\u0026deg;, resting on a chair arm. The mean of three attempts was recorded. Probable sarcopenia was defined using EWGSOP2 cut-off points: \u0026lt;27 kg for men and \u0026lt;\u0026thinsp;16 kg for women [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. This variable was dichotomized as \u0026ldquo;yes\u0026rdquo; or \u0026ldquo;no.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cem\u003eMobility.\u003c/em\u003e Mobility was assessed via gait speed, measured over a 5 m walk at usual pace. Patients were categorized as having gait speed\u0026thinsp;\u0026lt;\u0026thinsp;0.8 m/s or \u0026ge;\u0026thinsp;0.8 m/s.\u003c/p\u003e\u003cp\u003e\u003cem\u003eFrailty.\u003c/em\u003e Frailty was evaluated using the Fried Frailty Phenotype [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], comprising five criteria: unintentional weight loss (\u0026ge;\u0026thinsp;4.5 kg or \u0026gt;\u0026thinsp;5% body weight in the past year), exhaustion (based on two CES-D scale items), low physical activity (\u0026lt;\u0026thinsp;383 kcal/week for men; \u0026lt;270 kcal/week for women), weakness (HGS below sex- and BMI-specific thresholds), and slowness (gait speed below sex- and height-specific cut-offs). HGS was assessed as described above. Patients were classified as frail (\u0026ge;\u0026thinsp;3 criteria), pre-frail (1\u0026ndash;2), or robust (0).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\u003ch2\u003e2.3.2 Outcomes\u003c/h2\u003e\u003cp\u003ePostoperative outcomes were monitored for 30 days following surgery. In cases of discharge, electronic health records were reviewed to identify readmissions due to surgical complications. Postoperative complications (POCs) were classified according to the Clavien\u0026ndash;Dindo (CD) system [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], ranging from minor deviations (grade I) to death (grade V). Morbidity was categorized as minor (CD grades I\u0026ndash;II) or major (CD\u0026thinsp;\u0026ge;\u0026thinsp;III), and further dichotomized as \u0026ldquo;no/minor\u0026rdquo; vs. \u0026ldquo;major\u0026rdquo; complications.\u003c/p\u003e\u003cp\u003eICU admission was defined as postoperative transfer to the intermediate care unit and categorized as \u0026ldquo;yes\u0026rdquo; or \u0026ldquo;no.\u0026rdquo; Length of stay (LOS) was defined as the number of days from surgery to hospital discharge and was categorized as \u0026le;\u0026thinsp;10 or \u0026gt;\u0026thinsp;10 days (prolonged LOS), based on the sample median. Readmission was defined as any hospital readmission within 30 days post-discharge. Reintervention referred to any additional surgical procedure required postoperatively.\u003c/p\u003e\u003cp\u003eA composite variable, postoperative burden, was created to indicate patients with at least one adverse postoperative outcome, categorized as \u0026ldquo;yes\u0026rdquo; or \u0026ldquo;no.\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\u003ch2\u003e2.3.3 Covariates\u003c/h2\u003e\u003cp\u003ePatient characteristics were extracted from medical records and dichotomized as follows: age (\u0026lt;\u0026thinsp;65 vs. \u0026ge;65 years), sex (female vs. male), unintentional weight loss (no vs. yes), BMI (\u0026lt;\u0026thinsp;30 vs. \u0026ge;30 kg/m\u0026sup2;), number of comorbidities (\u0026lt;\u0026thinsp;3 vs. \u0026ge;3; sample median), CCI (\u0026lt;\u0026thinsp;5 vs. \u0026ge;5; sample median), MUST score (low vs. medium/high), neoadjuvant therapy (no vs. yes), tumor stage (I\u0026ndash;II vs. III\u0026ndash;IV), and tumor type (first diagnosis vs. local recurrence/metastasis).\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Statistical Analysis\u003c/h2\u003e\u003cp\u003eDescriptive data were presented as absolute numbers and percentages for categorical variables. For continuous variables, distributions were assessed, and results were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) or median and interquartile range (IQR), as appropriate. Associations between patient characteristics or physiological reserve markers and postoperative outcomes were evaluated using the chi-square test (if all cell counts\u0026thinsp;\u0026gt;\u0026thinsp;5) or Fisher\u0026rsquo;s exact test (if any cell count\u0026thinsp;\u0026le;\u0026thinsp;5). Relative risk (RR) with 95% confidence intervals (CI) was calculated. Physiological reserve markers with p\u0026thinsp;\u0026le;\u0026thinsp;0.05 in the bivariate analysis were included in binary logistic regression models, adjusted for confounding variables (p\u0026thinsp;\u0026lt;\u0026thinsp;0.20 in bivariate analysis), to assess their prognostic value for adverse postoperative outcomes. Missing data were handled using the multiple imputation command in the statistical software. The significance level was set at two-sided p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Analyses were performed using SPSS version 29.0 (IBM Corp., Armonk, NY, USA).\u003c/p\u003e\u003c/div\u003e"},{"header":"3. RESULTS","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Patient Characteristics\u003c/h2\u003e\u003cp\u003eThe final cohort included 125 patients, with a mean age of 62.1\u0026thinsp;\u0026plusmn;\u0026thinsp;11.2 years. Most were male (74.4%) and under 65 years old (60.8%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Overall, 52.8% reported unintentional weight loss in the past year, 19.2% were classified as obese, 6.5% were at high risk of malnutrition according to the MUST, and 60% had a CCI\u0026thinsp;\u0026ge;\u0026thinsp;5 (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Slightly more than half (54.4%) had head and neck cancer. Most had stage I (27.2%) or IV disease (28.8%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Only 14.4% underwent neoadjuvant chemotherapy and/or radiotherapy. Regarding tumor type, 62.4% had a primary tumor, 24% had local recurrence, and 13.6% had metastatic tumors. Most surgeries (48%) lasted between 120 and 239 minutes (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographic and clinical characteristics of patients who underwent gastric and head and neck cancer surgery (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;125)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;125)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62.1\u0026thinsp;\u0026plusmn;\u0026thinsp;11.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;65 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76 (60.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;65 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49 (39.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e93 (74.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (25.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTumor site\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGastric\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57 (45.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHead and neck\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e68 (54.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (6.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e90 (72.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14 (11.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWidower\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (9.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (0.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo qualifications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (4.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (51.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBasic education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36 (29.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (8.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUniversity education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (6.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWeight loss (kilograms)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.0 [0.0; 6.0]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWeight loss (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59 (47.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e66 (52.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25.7 [22.6; 28.8]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;30 kg/m\u0026sup2;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e101 (80.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;30 kg/m\u0026sup2;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24 (19.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eComorbidities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (8.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21 (16.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21 (16.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3 or more\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72 (57.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eComorbidities (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53 (42.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72 (57.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCCI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.0 [4.0; 7.0]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCCI (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50 (40.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75 (60.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMUST score\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e97 (78.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 (14.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (6.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeoadjuvant therapy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e107 (85.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 (14.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTumor stage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34 (27.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eII\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21 (16.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIII\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (22.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36 (28.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnknown\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 (4.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTumor type\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFirst cancer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78 (62.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLocal recurrence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30 (24.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMetastasis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17 (13.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTime from diagnosis to surgery (days)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62.0 [45.0; 93.5]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of surgery (minutes)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e140.0 [102.0; 210.0]\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of surgery (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;120 minutes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43 (34.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e120\u0026ndash;239 minutes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60 (48.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;240 minutes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (17.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysical activity levels\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63 (50.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40 (32.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (17.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGait speed (meters/seconds)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGait speed (categorized)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.8 meters/seconds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (12.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;0.8 meters/seconds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e109 (87.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHandgrip strength (kilograms)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30.8\u0026thinsp;\u0026plusmn;\u0026thinsp;8.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProbable sarcopenia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e99 (79.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (20.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrailty phenotype\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRobust\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30 (24.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrefrail\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e69 (55.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrail\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26 (20.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePOCs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80 (64.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45 (36.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMinor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (64.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMajor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (35.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICU admission\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e67 (53.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58 (46.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLOS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;10 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e69 (55.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56 (44.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30-days readmission\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e96 (76.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (23.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30-days reintervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e106 (84.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19 (15.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePostoperative burden\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50 (40.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75 (60.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003csup\u003ea\u003c/sup\u003eAbbreviation: BMI, body mass index; CCI, charlson comorbidity index; ICU, intermediate care unit; LOS, length of stay; MUST, malnutrition universal screening tool; POCs, postoperative complications\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003csup\u003eb\u003c/sup\u003eFor categories, N (%) is given, for continues variables, mean (SD) or median [1st-3th quartile] were given were appropriate\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Surrogate Markers For Preoperative Physiological Reserve\u003c/h2\u003e\u003cp\u003eBased on patient-reported data, 50.4% of participants exhibited low levels of physical activity, 32.0% reported moderate levels, and 17.6% reported high levels (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The average gait speed was 1.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4 m/s, with 12.8% showing low mobility (\u0026lt;\u0026thinsp;0.8 m/s). Mean HGS was 30.8\u0026thinsp;\u0026plusmn;\u0026thinsp;8.6 kg, with 20.8% classified as having probable sarcopenia. Additionally, 24% were robust, 55.2% pre-frail, and 20.8% frail (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Postoperative Outcomes\u003c/h2\u003e\u003cp\u003eOverall, 36% of patients experienced postoperative complications, 35.6% of which were classified as major (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Nearly half required ICU admission (46.4%), and 44.8% had a length of stay (LOS) longer than 10 days. Additionally, 23.2% were readmitted, 15.2% required reintervention within 30 days of discharge, and 60% experienced a composite postoperative burden (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.4 Patient Characteristics and Postoperative Outcomes\u003c/h2\u003e\u003cp\u003eBivariate analysis was performed to assess associations between baseline clinical and demographic characteristics and postoperative outcomes, with relative risks calculated (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). POCs were significantly associated with stage III\u0026ndash;IV tumors (RR: 2.05; 95% CI: 1.20\u0026ndash;3.51; p\u0026thinsp;=\u0026thinsp;0.005). ICU admission was associated with male sex (RR: 2.98; 95% CI: 1.42\u0026ndash;6.27; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). LOS\u0026thinsp;\u0026gt;\u0026thinsp;10 days was associated with stage III\u0026ndash;IV tumors (RR: 1.77; 95% CI: 1.15\u0026ndash;2.72; p\u0026thinsp;=\u0026thinsp;0.006), and 30-day readmission with local recurrence or metastasis (RR: 2.04; 95% CI: 1.08\u0026ndash;3.86; p\u0026thinsp;=\u0026thinsp;0.031). Composite postoperative burden was associated with male sex (RR: 1.81; 95% CI: 1.13\u0026ndash;2.89; p\u0026thinsp;=\u0026thinsp;0.003) and stage III\u0026ndash;IV tumors (RR: 1.43; 95% CI: 1.05\u0026ndash;1.96; p\u0026thinsp;=\u0026thinsp;0.018). No significant associations were found between 30-day reintervention and baseline characteristics. Variables with p\u0026thinsp;\u0026lt;\u0026thinsp;0.20 in the bivariate analysis were included as covariates in the logistic regression models.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographic and clinical characteristics of patients who underwent gastric and head and neck cancer surgery and associations with postoperative outcomes (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;125)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"22\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c18\" colnum=\"18\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c19\" colnum=\"19\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c20\" colnum=\"20\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c21\" colnum=\"21\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c22\" colnum=\"22\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003ePOCs\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eMajor complications (CD\u0026thinsp;\u0026ge;\u0026thinsp;III)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eICU admission\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e\u003cp\u003eLOS (\u0026gt;\u0026thinsp;10 days)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c16\" namest=\"c14\"\u003e\u003cp\u003e30-days readmission\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c19\" namest=\"c17\"\u003e\u003cp\u003e30-days reintervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c22\" namest=\"c20\"\u003e\u003cp\u003ePostoperative burden\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c17\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c18\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c19\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c20\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c21\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c22\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge (categorized)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.690\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.855\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.716\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.665\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.453\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.881\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;65 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23 (51.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9 (11.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e36 (62.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e33 (58.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e19 (65.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e46 (61.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;65 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22 (48.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.48 (0.94\u0026ndash;2.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7 (14.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.21 (0.48\u0026ndash;3.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e22 (37.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.95 (0.64\u0026ndash;1.40)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e23 (41.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.08 (0.73\u0026ndash;1.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e10 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.82 (0.42\u0026ndash;1.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1.40 (0.61\u0026ndash;3.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e29 (38.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e0.98 (0.73\u0026ndash;1.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.533\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.579\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.169\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.629\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e6 (10.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e11 (19.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e6 (20.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e2 (10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e12 (16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35 (77.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.20 (0.68\u0026ndash;2.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (11.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.76 (0.28\u0026ndash;2.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e52 (89.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e2.98 (1.42\u0026ndash;6.27)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e45 (80.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.41 (0.83\u0026ndash;2.37)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e23 (79.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1.32 (0.59\u0026ndash;2.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e17 (89.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e2.92 (0.71\u0026ndash;11.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e63 (84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e\u003cb\u003e1.81 (1.13\u0026ndash;2.89)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeight loss (categorized)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.171\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.770\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.607\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.108\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17 (37.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (8.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e23 (39.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e22 (39.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e13 (44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e31 (41.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28 (62.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.47 (0.90\u0026ndash;2.40)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.97 (0.73\u0026ndash;5.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e35 (60.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.36 (0.92\u0026ndash;2.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e34 (60.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.38 (0.92\u0026ndash;2.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e16 (55.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1.10 (0.58\u0026ndash;2.09)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e0.80 (0.35\u0026ndash;1.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e44 (58.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.27 (0.94\u0026ndash;1.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBMI (categorized)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.865\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.190\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.910\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.591\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.853\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;30 kg/m\u0026sup2;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e36 (80.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (10.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e50 (86.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e45 (80.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e25 (86.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e16 (84.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e61 (81.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;30 kg/m\u0026sup2;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9 (20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.05 (0.59\u0026ndash;1.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (20.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.91 (0.73\u0026ndash;4.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e8 (13.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.67 (0.37\u0026ndash;1.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e11 (19.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.03 (0.63\u0026ndash;1.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e4 (13.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.67 (0.26\u0026ndash;1.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e3 (15.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e0.79 (0.25\u0026ndash;2.49)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e14 (18.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e0.97 (0.67\u0026ndash;1.40)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eComorbidities (categorized)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.422\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.347\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.173\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.763\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.594\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.301\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e15 (33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (31.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e22 (37.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e20 (35.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e13 (44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e7 (36.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e29 (38.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30 (66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.47 (0.89\u0026ndash;2.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (68.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.62 (0.60\u0026ndash;4.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e36 (62.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.20 (0.81\u0026ndash;1.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e36 (64.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.33 (0.87\u0026ndash;2.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e16 (55.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.91 (0.48\u0026ndash;1.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1.26 (0.53\u0026ndash;2.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e46 (61.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.17 (0.86\u0026ndash;1.58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCCI (categorized)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.704\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.444\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.607\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.545\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.760\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.264\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17 (37.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e20 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e21 (37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e13 (44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e7 (36.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e27 (36.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28 (62.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.10 (0.68\u0026ndash;1.78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (14.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.47 (0.54\u0026ndash;3.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e38 (65.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.27 (0.84\u0026ndash;1.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e35 (62.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.11 (0.74\u0026ndash;1.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e16 (55.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.82 (0.43\u0026ndash;1.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1.14 (0.48\u0026ndash;2.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e48 (64.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.19 (0.87\u0026ndash;1.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMUST score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.359\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.744\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.187\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e0.052\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.109\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33 (73.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12 (12.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e41 (73.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e39 (70.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e19 (67.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e14 (77.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e54 (72.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedium and High\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12 (26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.36 (0.82\u0026ndash;2.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4 (15.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.24 (0.44\u0026ndash;3.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e15 (26.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.36 (0.91\u0026ndash;2.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e16 (29.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e1.53 (1.04\u0026ndash;2.26)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e9 (32.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1.77 (0.91\u0026ndash;3.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e4 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1.07 (0.38\u0026ndash;2.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e19 (25.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.31 (0.98\u0026ndash;1.76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNeoadjuvant therapy\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.196\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.070\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.349\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39 (86.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12 (11.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e52 (89.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e48 (85.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e28 (96.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e19 (100.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e66 (88.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.91 (0.45\u0026ndash;1.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.98 (0.72\u0026ndash;5.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e6 (10.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.69 (0.35\u0026ndash;1.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e8 (14.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.99 (0.57\u0026ndash;1.73)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e1 (3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.21 (0.03\u0026ndash;1.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e9 (12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e0.81 (0.50\u0026ndash;1.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTumor stage\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.605\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e\u003cb\u003e0.018\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI-II\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13 (29.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6 (10.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e20 (36.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e18 (32.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e10 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e27 (37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIII-IV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31 (70.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e2.05 (1.20\u0026ndash;3.51)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9 (14.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.29 (0.49\u0026ndash;3.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e35 (63.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.50 (0.99\u0026ndash;2.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e37 (67.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e1.77 (1.15\u0026ndash;2.72)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e19 (65.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1.63 (0.83\u0026ndash;3.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e0.95 (0.42\u0026ndash;2.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e45 (62.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e\u003cb\u003e1.43 (1.05\u0026ndash;1.96)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTumor type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.337\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.574\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.070\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.497\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFirst cancer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31 (68.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (14.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e31 (53.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e40 (71.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e13 (44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e8 (42.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e45 (60.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLocal recurrence and metastasis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14 (31.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.75 (0.45\u0026ndash;1.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (10.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.75 (0.28\u0026ndash;2.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e27 (46.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.45 (1.00-2.09)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e16 (28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.66 (0.42\u0026ndash;1.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e16 (55.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e2.04 (1.08\u0026ndash;3.86)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e11 (57.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e2.28 (0.99\u0026ndash;5.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u003cp\u003e30 (40.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.11 (0.83\u0026ndash;1.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"22\"\u003e\u003csup\u003ea\u003c/sup\u003eAbbreviation: BMI, body mass index; CCI, charlson comorbidity index; CD, clavien-dindo; ICU, intermediate care unit; LOS, length of stay; MUST, malnutrition universal screening tool; POCs, postoperative complications; RR, relative risk\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"22\"\u003e\u003csup\u003eb\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e-value obtained by the Chi-square test or Fisher\u0026rsquo;s exact test\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"22\"\u003e\u003csup\u003ec\u003c/sup\u003eBold = statistically significant, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e3.5 Surrogate Markers For Preoperative Physiological Reserve And Postoperative Outcomes\u003c/h2\u003e\u003cp\u003eBivariate analysis was conducted to assess the association between surrogate markers of preoperative physiological reserve and postoperative outcomes, with relative risks (RRs) calculated (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Patients with low physical activity had a 1.61-fold higher risk of ICU admission compared to those with moderate/high activity (95% CI: 1.08\u0026ndash;2.40; p\u0026thinsp;=\u0026thinsp;0.015). Low gait speed (\u0026lt;\u0026thinsp;0.8 m/s) was associated with a 2.17-fold higher risk of 30-day readmission (95% CI: 1.11\u0026ndash;4.23; p\u0026thinsp;=\u0026thinsp;0.037) and showed a trend toward increased risk of 30-day reintervention (RR: 2.43; 95% CI: 1.01\u0026ndash;5.84; p\u0026thinsp;=\u0026thinsp;0.055).\u003c/p\u003e\u003cp\u003ePatients with probable sarcopenia had increased risk of POCs (RR: 1.72; 95% CI: 1.09\u0026ndash;2.72; p\u0026thinsp;=\u0026thinsp;0.033), ICU admission (RR: 1.58; 95% CI: 1.10\u0026ndash;2.27; p\u0026thinsp;=\u0026thinsp;0.029), prolonged LOS (RR: 1.66; 95% CI: 1.14\u0026ndash;2.41; p\u0026thinsp;=\u0026thinsp;0.018), and composite postoperative burden (RR: 1.38; 95% CI: 1.05\u0026ndash;1.82; p\u0026thinsp;=\u0026thinsp;0.048). Frailty (pre-frail\u0026thinsp;+\u0026thinsp;frail) was associated with increased risk of ICU admission (RR: 2.30; 95% CI: 1.17\u0026ndash;4.52; p\u0026thinsp;=\u0026thinsp;0.004) and postoperative burden (RR: 1.84; 95% CI: 1.12\u0026ndash;3.00; p\u0026thinsp;=\u0026thinsp;0.003), compared to robust patients.\u003c/p\u003e\u003cp\u003eBinary logistic regression analyses were performed to evaluate the predictive power of markers significantly associated (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) with any postoperative outcome in the bivariate analysis (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e), as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and detailed in the \u003cem\u003eSupplementary Table\u0026nbsp;1\u003c/em\u003e. Models were adjusted for confounders identified from baseline characteristics with p\u0026thinsp;\u0026lt;\u0026thinsp;0.20 in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003eLow physical activity remained a significant predictor of ICU admission after adjustment (OR: 2.34; 95% CI: 1.03\u0026ndash;5.35; p\u0026thinsp;=\u0026thinsp;0.043).\u003c/p\u003e\u003cp\u003eLow gait speed predicted 30-day readmission (OR: 3.08; 95% CI: 1.03\u0026ndash;9.17; p\u0026thinsp;=\u0026thinsp;0.044), but this association lost significance after adjustment. However, it remained a significant predictor of 30-day reintervention (OR: 5.22; 95% CI: 1.23\u0026ndash;22.19; p\u0026thinsp;=\u0026thinsp;0.025).\u003c/p\u003e\u003cp\u003eProbable sarcopenia predicted the occurrence of POCs (OR: 2.56; 95% CI: 1.06\u0026ndash;6.17; p\u0026thinsp;=\u0026thinsp;0.036) and ICU admission (OR: 2.67; 95% CI: 1.08\u0026ndash;6.58; p\u0026thinsp;=\u0026thinsp;0.033), though these associations lost significance after adjustment. Nonetheless, it remained an independent predictor of prolonged LOS (OR: 3.18; 95% CI: 1.15\u0026ndash;8.81; p\u0026thinsp;=\u0026thinsp;0.026).\u003c/p\u003e\u003cp\u003eFinally, frailty (pre-frail\u0026thinsp;+\u0026thinsp;frail) independently predicted ICU admission (OR: 5.73; 95% CI: 1.79\u0026ndash;18.34; p\u0026thinsp;=\u0026thinsp;0.003) and composite postoperative burden (OR: 4.58; 95% CI: 1.60\u0026ndash;13.08; p\u0026thinsp;=\u0026thinsp;0.004), even after adjustment for confounders.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSurrogate markers for preoperative physiological reserve of patients who underwent gastric and head and neck cancer surgery and associations with postoperative outcomes (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;125)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"22\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c18\" colnum=\"18\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c19\" colnum=\"19\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c20\" colnum=\"20\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c21\" colnum=\"21\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c22\" colnum=\"22\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003ePOCs\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eMajor complications (CD\u0026thinsp;\u0026ge;\u0026thinsp;III)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eICU admission\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e\u003cp\u003eLOS (\u0026gt;\u0026thinsp;10 days)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c16\" namest=\"c14\"\u003e\u003cp\u003e30-days readmission\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c19\" namest=\"c17\"\u003e\u003cp\u003e30-days reintervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c22\" namest=\"c20\"\u003e\u003cp\u003ePostoperative burden\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c17\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c18\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c19\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c20\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c21\"\u003e\u003cp\u003eRR (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c22\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePhysical activity levels\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.710\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.569\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.591\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.398\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.808\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.058\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh and moderate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21 (46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9 (56.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e22 (37.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e26 (46.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e12 (41.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e32 (42.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24 (53.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.12 (0.70\u0026ndash;1.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7 (43.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.77 (0.30\u0026ndash;1.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e36 (62.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e1.61 (1.08\u0026ndash;2.40)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e30 (53.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.14 (0.77\u0026ndash;1.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e17 (58.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1.39 (0.73\u0026ndash;2.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e0.89 (0.39\u0026ndash;2.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e43 (57.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.32 (0.99\u0026ndash;1.77)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGait speed (categorized)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.267\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.431\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.432\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.421\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e\u003cb\u003e0.037\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.055\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e0.275\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;0.8 m/s\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37 (82.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13 (81.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e49 (84.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e47 (83.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e22 (75.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e14 (73.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e63 (84.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.8 m/s\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8 (17.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.47 (0.85\u0026ndash;2.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (18.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.57 (0.50\u0026ndash;4.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e9 (15.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.25 (0.77\u0026ndash;2.02)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e9 (16.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.30 (0.80\u0026ndash;2.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e7 (24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e2.17 (1.11\u0026ndash;4.23)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e5 (26.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e\u003cb\u003e2.43 (1.01\u0026ndash;5.84)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e12 (16.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1.30 (0.94\u0026ndash;1.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProbable sarcopenia\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.033\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.742\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e0.018\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.190\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31 (68.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12 (75.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e41 (70.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e39 (69.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e20 (69.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e55 (73.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14 (31.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.72 (1.09\u0026ndash;2.72)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4 (25.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.27 (0.45\u0026ndash;3.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e17 (29.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e1.58 (1.10\u0026ndash;2.27)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e17 (30.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cb\u003e1.66 (1.14\u0026ndash;2.41)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e9 (31.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1.71 (0.89\u0026ndash;3.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e7 (36.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e2.22 (0.97\u0026ndash;5.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e20 (26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e\u003cb\u003e1.38 (1.05\u0026ndash;1.82)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFrailty phenotype\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e\u003cp\u003e0.091\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e\u003cp\u003e0.080\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c19\"\u003e\u003cp\u003e0.241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c22\"\u003e\u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRobust\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8 (17.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4 (25.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e7 (12.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e9 (16.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e3 (10.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e2 (10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e11 (14.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrefrail and frail\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37 (82.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.46 (0.77\u0026ndash;2.78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12 (75.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.95 (0.33\u0026ndash;2.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e51 (87.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e2.30 (1.17\u0026ndash;4.52)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e47 (83.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.65 (0.92\u0026ndash;2.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e\u003cp\u003e26 (89.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e2.74 (0.89\u0026ndash;8.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e\u003cp\u003e17 (89.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u003cp\u003e2.68 (0.66\u0026ndash;10.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c20\"\u003e\u003cp\u003e64 (85.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c21\"\u003e\u003cp\u003e\u003cb\u003e1.84 (1.12-3.00)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c22\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"22\"\u003e\u003csup\u003ea\u003c/sup\u003eAbbreviation: CD, clavien-dindo; ICU, intermediate care unit; LOS, length of stay; POCs, postoperative complications; RR, relative risk\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"22\"\u003e\u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e-value obtained by the Chi-square test or Fisher\u0026rsquo;s exact test\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"22\"\u003e\u003csup\u003ec\u003c/sup\u003eBold = statistically significant, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":" 4. DISCUSSION","content":"\u003cp\u003eThis study evaluated the predictive value of surrogate markers of preoperative physiological reserve for short-term postoperative outcomes in cancer patients. The findings indicate that low physical activity, frailty, low gait speed, and probable sarcopenia are significant and independent predictors of adverse postoperative outcomes. These results highlight the clinical utility of assessing physiological reserve to identify high-risk patients and guide tailored preoperative interventions.\u003c/p\u003e\n\u003cp\u003eThe postoperative morbidity rate observed in this study (36%) is consistent with previously reported rates for gastric and head and neck cancer surgeries, which range between 23% and 37%, depending on surgical complexity and patient ‘characteristics [20–22]. These findings reinforce the importance of employing preoperative screening tools to predict short-term postoperative risks. Identifying modifiable preoperative risk factors is crucial, as targeted interventions such as prehabilitation may help mitigate surgical risks and improve patient outcomes.\u003c/p\u003e\n\u003cp\u003eLow levels of physical activity are associated with reduced functional capacity, lower cardiovascular and muscular endurance, and impaired recovery potential, necessitating additional postoperative care [7, 23]. In our study, low physical activity was identified as an independent predictor of ICU admission, emphasizing its pivotal role in surgical resilience. This finding suggests that incorporating preoperative assessments with practical tools such as the IPAQ can enhance the prediction of postoperative care needs and optimize resource allocation. Supporting this, Toriumi et al. [24] also applied the IPAQ in patients undergoing gastrectomy and found that low physical activity levels were independently associated with a higher incidence of POCs. However, their analysis excluded CD grade 1 complications, considering only those classified as grade 2 or higher as clinically significant. Additionally, compared to our study, the sample analyzed by Toriumi et al. [24] had a higher proportion of patients aged ≥ 65 years. Similarly, a systematic review and meta-analysis by Steffen et al. [7], which included 13 studies, demonstrated that higher preoperative physical activity levels were significantly associated with shorter LOS and improved postoperative quality of life in cancer surgery patients. However, this meta-analysis did not find a significant association between preoperative physical activity and POCs. The authors attributed this discrepancy to the heterogeneity in physical activity measurement methods and outcome definitions across studies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn our study, reduced gait speed was an independent predictor of reintervention within 30 days, likely due to its well-established role as an indicator of overall functional status and frailty. Slow gait speed reflects compromised physical function and muscle strength, which may hinder postoperative recovery and increase the likelihood of reintervention [25, 26]. Prior research has also identified an association between reduced gait speed and adverse postoperative outcomes. For instance, Chandoo et al. [27] found that a walking speed below 0.8 m/s was an independent predictor of postoperative medical complications in elderly patients undergoing curative gastrectomy. Similarly, Karlsson et al. [28] demonstrated that better preoperative physical performance, including higher gait speed, was associated with lower rates of severe postoperative complications and a reduced likelihood of discharge to healthcare facilities in elderly patients undergoing abdominal cancer surgery. Notably, both studies focused exclusively on elderly patients, whereas our sample had a mean age of 62.1 ± 11.2 years, with 60.8% of patients aged \u0026lt; 65 years. This suggests that the predictive value of low gait speed for complications may also extend to younger cancer patient.\u003c/p\u003e\n\u003cp\u003eProbable sarcopenia was a significant predictor of POCs and ICU admission; however, these associations lost statistical significance after adjusting for confounding variables. This may be due to the small sample size, which affects the precision of odds ratio estimates. Nevertheless, our study found that probable sarcopenia was an independent predictor of prolonged LOS. Kuwada et al. [29] similarly reported that gastric cancer patients with sarcopenia, as defined by sex-specific quartile-based cut-off values of the skeletal muscle area to body surface area index measured on preoperative computed tomography scans at the L3 level, had significantly longer hospital stays compared to non-sarcopenic patients. Despite its clinical relevance, sarcopenia remains underdiagnosed and undertreated, likely due to the complexity of its assessment [30]. Few studies have investigated whether probable sarcopenia can serve as a predictor of surgical outcomes in cancer patients. However, existing evidence suggests that probable sarcopenia is an independent predictor of postoperative pneumonia in esophageal cancer patients [31] and a predictor of 12-month mortality in older cancer patients undergoing treatment [32]. Given its ease of assessment through a simple and rapid HGS test, probable sarcopenia screening may be valuable in identifying high-risk surgical patients and guiding prehabilitation strategies.\u003c/p\u003e\n\u003cp\u003eIn our study, frailty, as assessed by the Fried Frailty Phenotype, was a robust independent predictor of both postoperative burden (composite outcome) and ICU admission. Frail patients have lower physiological reserve, which may lead to prolonged and complicated recovery, necessitating intensive postoperative care. Supporting this, Ding et al. [33] conducted an observational study with 406 elderly patients undergoing gastric cancer surgery and found that preoperative frailty, assessed using the frailty phenotype, was associated with total complications, prolonged LOS, and 90-day hospital readmission. Similarly, Panayi et al. [34] performed a systematic review and meta-analysis of 16 studies in various surgical populations and concluded that frailty, assessed using the modified frailty index (mFI), is a prognostic indicator that increases the risk of postoperative morbidity and mortality. Another systematic review and meta-analysis [35] demonstrated that preoperative frailty, assessed using validated tools, including clinical scales and laboratory markers, was associated with an increased risk of both total and major POCs in patients with digestive system tumors. Methodological differences, including variations in frailty classification, discrepancies in postoperative outcome definitions, and the relatively small sample size of our study, may have contributed to differences in findings compared to previous studies.\u003c/p\u003e\n\u003cp\u003eThe results of our study underscore the importance of assessing preoperative physiological reserve using surrogate markers to anticipate postoperative outcomes. Screening for conditions such as low physical activity, frailty, reduced gait speed, and probable sarcopenia is essential to identify high-risk patients and guide tailored preoperative interventions (e.g. prehabilitation programs), which should be systematically incorporated into surgical care pathways [36]. A recent systematic review and meta-analysis [37] demonstrated that prehabilitation can reduce POCs and decrease LOS in frail patients undergoing colorectal cancer surgery. Therefore, healthcare professionals can use this information to tailor preoperative interventions and postoperative care plans, ultimately improving patient outcomes. This study contributes to the growing body of evidence supporting the evaluation of physiological reserve as a strategy to optimize surgical outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.1 Limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study's strength lies in its comprehensive evaluation of multiple markers of physiological reserve and their independent associations with postoperative outcomes. However, we acknowledge that the generalization of these results may be limited due to the retrospective design and potential selection bias. Additionally, the single-center design may limit the extrapolation of results to a broader population. Nonetheless, the findings of this study emphasize the importance of comprehensive preoperative evaluation in identifying at-risk patients and implementing preoperative optimization strategies, such as prehabilitation. These findings contribute to advancing standard care for patients undergoing oncologic surgery and underscore the need for future prospective research to validate and expand upon these findings.\u003c/p\u003e"},{"header":"5.\tCONCLUSION","content":"\u003cp\u003eOur study highlights the pivotal role of preoperative physiological markers in anticipating and managing short-term adverse postoperative outcomes. The identified predictors emphasize the need for an integrated approach to patient care, incorporating prehabilitation strategies tailored to individual risk profiles. Future prospective studies and interventions informed by these findings may further refine preoperative care paradigms, ultimately improving outcomes and quality of life for this patient population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Portuguese Foundation of Science and Technology (FCT) (PROTECT project (grant PTDC/SAU-DES/7945/2020; 10.54499/PTDC/SAU-DES/7945/2020). The Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), part of the Laboratory for Integrative and Translational Research in Population Health (ITR), are funded by FCT (grants UIDB/00617/2020 https://doi.org/10.54499/UIDB/00617/2020; UIDP/00617/2020 https://doi.org/10.54499/UIDP/00617/2020 and LA/P/0064/2020, respectively). \u0026nbsp;Clara Gentil-Daher, Carolina Castro and João Antunes are supported by an individual grant from FCT (10.54499/UI/BD/150674/2020; 2022.13379.BD; SFRH/BD/147776/2019, respectively).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCRediT authorship contribution statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCGD:\u003c/strong\u003e Conceptualization, Funding acquisition, Methodology, Data curation, Investigation, Formal Analysis, Writing – original draft, Writing – review \u0026amp; editing, Visualization. \u003cstrong\u003eCC:\u0026nbsp;\u003c/strong\u003eData curation, Investigation. \u003cstrong\u003eJA\u003c/strong\u003e: Data curation, Investigation. \u003cstrong\u003ePM\u003c/strong\u003e: Data curation, Investigation. \u003cstrong\u003eLLS\u003c/strong\u003e: Project administration, Resources, Supervision. \u003cstrong\u003eDMG\u003c/strong\u003e: Conceptualization, Funding acquisition, Methodology, Writing – review \u0026amp; editing, Project administration, Resources, Supervision. \u003cstrong\u003eAll authors\u003c/strong\u003e read and approved the final manuscrip.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Portuguese Oncology Institute of Porto (CES-IPOP 03).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSullivan, R., Alatise, O. I., Anderson, B. O., Audisio, R., Autier, P., Aggarwal, A., Balch, C., Brennan, M. F., Dare, A., D\u0026apos;Cruz, A., Eggermont, A. M., Fleming, K., Gueye, S. 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Sarcopenia: revised European consensus on definition and diagnosis. \u003cem\u003eAge and ageing\u003c/em\u003e, \u003cem\u003e48\u003c/em\u003e(1), 16\u0026ndash;31. https://doi.org/10.1093/ageing/afy169\u003c/li\u003e\n\u003cli\u003eFried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., McBurnie, M. A., \u0026amp; Cardiovascular Health Study Collaborative Research Group (2001). Frailty in older adults: evidence for a phenotype. \u003cem\u003eThe journals of gerontology. Series A, Biological sciences and medical sciences\u003c/em\u003e, \u003cem\u003e56\u003c/em\u003e(3), M146\u0026ndash;M156. https://doi.org/10.1093/gerona/56.3.m146\u003c/li\u003e\n\u003cli\u003eDindo, D., Demartines, N., \u0026amp; Clavien, P. A. (2004). Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of surgery, 240(2), 205\u0026ndash;213. https://doi.org/10.1097/01.sla.0000133083.54934.ae \u003c/li\u003e\n\u003cli\u003eGalata C, Ronellenfitsch U, Blank S, Rei\u0026szlig;felder C, Hardt J. Postoperative morbidity and failure to rescue in surgery for gastric cancer: a single center retrospective cohort study of 1107 patients from 1972 to 2014. Cancers (Basel). 2020;12(7):1953. https://doi.org/10.3390/cancers12071953\u003c/li\u003e\n\u003cli\u003eBartlett EK, Roses RE, Kelz RR, et al. Morbidity and mortality after total gastrectomy for gastric malignancy using the American College of Surgeons National Surgical Quality Improvement Program database. Surgery. 2014;156(2):298\u0026ndash;304. https://doi.org/10.1016/j.surg.2014.03.022\u003c/li\u003e\n\u003cli\u003eAli, B., Choi, E. E., Barlas, V., Petersen, T. R., Menon, N. G., \u0026amp; Morrell, N. T. (2021). Risk Factors for 30-Day Mortality After Head and Neck Microsurgical Reconstruction for Cancer: NSQIP Analysis. OTO open, 5(3), 2473974X211037257. https://doi.org/10.1177/2473974X211037257\u003c/li\u003e\n\u003cli\u003eMatsumura, K., Takami, A., Tajima, S., Sasaki, Y., Kato, N., \u0026amp; Makino, M. (2024). Effect of preoperative physical activity on postoperative outcomes in esophageal cancer. Journal of physical therapy science, 36(9), 557\u0026ndash;563. https://doi.org/10.1589/jpts.36.557\u003c/li\u003e\n\u003cli\u003eToriumi, T., Yamashita, H., Kawasaki, K., Okumura, Y., Wakamatsu, K., Yagi, K., Aikou, S., Nomura, S., \u0026amp; Seto, Y. (2020). Preoperative Exercise Habits are Associated with Post-gastrectomy Complications. \u003cem\u003eWorld journal of surgery\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(8), 2736\u0026ndash;2742. https://doi.org/10.1007/s00268-020-05493-3\u003c/li\u003e\n\u003cli\u003eDilektasli, A. G., \u0026Ouml;zt\u0026uuml;rk, N. A. A., Kerimoğlu, D., Odabaş, A., Yaman, M. T., Dogan, A., Demirdogen, E., Guclu, O. A., Coşkun, F., Ursavas, A., \u0026amp; Karadağ, M. (2025). Slow gait speed is associated with frailty, activities of daily living and nutritional status in in-patient pulmonology patients. Aging clinical and experimental research, 37(1), 133. https://doi.org/10.1007/s40520-025-03040-5\u003c/li\u003e\n\u003cli\u003eItoh, S., Yoshizumi, T., Sakata, K., et al. (2019). Slow gait speed is a risk factor for complications after hepatic resection. Journal of Gastrointestinal Surgery, 23(9), 1810\u0026ndash;1816. https://doi.org/10.1007/s11605-018-3993-5\u003c/li\u003e\n\u003cli\u003eChandoo, A., Chi, C. H., Ji, W., Huang, Y., Chen, X. D., Zhang, W. T., Wu, R. S., \u0026amp; Shen, X. (2018). Gait speed predicts post-operative medical complications in elderly gastric cancer patients undergoing gastrectomy. \u003cem\u003eANZ journal of surgery\u003c/em\u003e, \u003cem\u003e88\u003c/em\u003e(7-8), 723\u0026ndash;726. https://doi.org/10.1111/ans.14325\u003c/li\u003e\n\u003cli\u003eKarlsson, E., Egenvall, M., Farahnak, P., Bergenmar, M., Nygren-Bonnier, M., Franz\u0026eacute;n, E., \u0026amp; Rydwik, E. (2018). Better preoperative physical performance reduces the odds of complication severity and discharge to care facility after abdominal cancer resection in people over the age of 70 - A prospective cohort study. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 44(11), 1760\u0026ndash;1767. https://doi.org/10.1016/j.ejso.2018.08.011\u003c/li\u003e\n\u003cli\u003eKuwada, K., Kuroda, S., Kikuchi, S., Yoshida, R., Nishizaki, M., Kagawa, S., \u0026amp; Fujiwara, T. (2018). Sarcopenia and Comorbidity in Gastric Cancer Surgery as a Useful Combined Factor to Predict Eventual Death from Other Causes. \u003cem\u003eAnnals of Surgical Oncology\u003c/em\u003e, 25, 1160-1166. https://doi.org/10.1245/s10434-018-6354-4\u003c/li\u003e\n\u003cli\u003eKeller K. (2019). Sarcopenia. Sarkopenie. \u003cem\u003eWiener medizinische Wochenschrift (1946)\u003c/em\u003e, \u003cem\u003e169\u003c/em\u003e(7-8), 157\u0026ndash;172. https://doi.org/10.1007/s10354-018-0618-2\u003c/li\u003e\n\u003cli\u003eKurita, D., Oguma, J., Ishiyama, K., Hirano, Y., Kanamori, J., \u0026amp; Daiko, H. (2020). Handgrip Strength Predicts Postoperative Pneumonia After Thoracoscopic-Laparoscopic Esophagectomy for Patients with Esophageal Cancer. \u003cem\u003eAnnals of surgical oncology\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(9), 3173\u0026ndash;3181. https://doi.org/10.1245/s10434-020-08520-8\u003c/li\u003e\n\u003cli\u003eSousa, I. M., \u0026amp; Fayh, A. P. T. (2023). Is the ECOG-PS similar to the sarcopenia status for predicting mortality in older adults with cancer? A prospective cohort study. \u003cem\u003eSupportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e(6), 370. https://doi.org/10.1007/s00520-023-07845-w\u003c/li\u003e\n\u003cli\u003eDing, L., Miao, X., Jiang, X., Chen, L., Lu, J., Zhu, H., Guo, Y., Zhu, S., Xu, X., Hu, J., \u0026amp; Xu, Q. (2023). Adverse outcomes and health-ecological influencing factors of preoperative frailty among elderly patients with gastric cancer. \u003cem\u003eJournal of cancer research and clinical oncology\u003c/em\u003e, \u003cem\u003e149\u003c/em\u003e(10), 7043\u0026ndash;7051. https://doi.org/10.1007/s00432-023-04651-z\u003c/li\u003e\n\u003cli\u003ePanayi, A. C., Orkaby, A. R., Sakthivel, D., Endo, Y., Varon, D., Roh, D., Orgill, D. P., Neppl, R. L., Javedan, H., Bhasin, S., \u0026amp; Sinha, I. (2019). Impact of frailty on outcomes in surgical patients: A systematic review and meta-analysis. \u003cem\u003eAmerican journal of surgery\u003c/em\u003e, \u003cem\u003e218\u003c/em\u003e(2), 393\u0026ndash;400. https://doi.org/10.1016/j.amjsurg.2018.11.020\u003c/li\u003e\n\u003cli\u003eDing, L., Lu, J., Zhu, H., Zhu, S., Xu, X., Hua, H., Chen, L., Zhao, K., \u0026amp; Xu, Q. (2021). Effects of preoperative frailty on outcomes following surgery among patients with digestive system tumors: A systematic review and meta-analysis. \u003cem\u003eEuropean journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology\u003c/em\u003e, \u003cem\u003e47\u003c/em\u003e(12), 3040\u0026ndash;3048. https://doi.org/10.1016/j.ejso.2021.07.019\u003c/li\u003e\n\u003cli\u003eCoca-Martinez, M., \u0026amp; Carli, F. (2024). Prehabilitation: Who can benefit? \u003cem\u003eEuropean journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology\u003c/em\u003e, \u003cem\u003e50\u003c/em\u003e(5), 106979. https://doi.org/10.1016/j.ejso.2023.07.005\u003c/li\u003e\n\u003cli\u003eChang, M. C., Choo, Y. J., \u0026amp; Kim, S. (2023). Effect of prehabilitation on patients with frailty undergoing colorectal cancer surgery: a systematic review and meta-analysis. \u003cem\u003eAnnals of surgical treatment and research\u003c/em\u003e, \u003cem\u003e104\u003c/em\u003e(6), 313\u0026ndash;324. https://doi.org/10.4174/astr.2023.104.6.313\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"cancer patients, pre-operative risk assessment, physiological reserve, surgical oncology, postoperative outcomes","lastPublishedDoi":"10.21203/rs.3.rs-6901133/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6901133/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eTo mitigate surgery-related morbidity and mortality and elevate the standard of care for surgical patients, clinicians must leverage precise pre-operative risk assessment tools. This study aimed to investigate the predictive value of surrogate markers for preoperative physiological reserve in relation to postoperative outcomes.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe analyzed data from 125 patients undergoing elective surgery for gastric or head and neck cancer (December 2018 to June 2019), using binary logistic regression models, adjusted for confounders. Outcomes of interest were: postoperative complications, major complications, need for intermediate care unit, prolonged length of stay (\u0026gt;\u0026thinsp;10 days), 30-days readmission, 30-days reintervention and postoperative burden (patients who had\u0026thinsp;\u0026ge;\u0026thinsp;1 adverse postoperative outcome, among those mentioned above).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eLow physical activity (OR, 2.34; [95% CI, 1.03\u0026ndash;5.35], p\u0026thinsp;=\u0026thinsp;0.043) and frailty (OR, 5.73; [95% CI, 1.79\u0026ndash;18.34], p\u0026thinsp;=\u0026thinsp;0.003) increased the probability of intermediate care unit admission. Frailty predicted postoperative burden (OR, 4.58; [95% CI, 1.60-13.08], p\u0026thinsp;=\u0026thinsp;0.004). Low gait speed raised the likelihood of reintervention within 30 days (OR, 5.22; [95% CI, 1.23\u0026ndash;22.19], p\u0026thinsp;=\u0026thinsp;0.025). Probable sarcopenia heightened the odds of prolonged hospitalization (OR, 3.18; [95% CI, 1.15\u0026ndash;8.81], p\u0026thinsp;=\u0026thinsp;0.026).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eLow physical activity, low gait speed, probable sarcopenia and frailty are independent predictors of short-term adverse postoperative outcomes. The identified predictors emphasize the need for an integrated approach to patient care, incorporating prehabilitation strategies tailored to individual risk profiles.\u003c/p\u003e","manuscriptTitle":"Preoperative physiological reserve surrogate markers predict short-term adverse postoperative outcomes in cancer patients: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-05 06:54:37","doi":"10.21203/rs.3.rs-6901133/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"97be8b69-a41d-4b97-8c34-91efa7d69f86","owner":[],"postedDate":"August 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-12T03:08:45+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-05 06:54:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6901133","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6901133","identity":"rs-6901133","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}