{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:14:11Z","timestamp":1792782851079,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The University of Tokyo","id":[{"id":"https:\/\/ror.org\/057zh3y96","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Risk stratification before esophageal and gastric endoscopic submucosal dissection (ESD) in older adults often relies on age and comorbidity; however, these measures may not capture vulnerability reflected in routinely collected claims data. We aimed to evaluate the claims-based frailty and short-term adverse events association after esophageal and gastric endoscopic submucosal dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a nationwide Japanese administrative database to identify patients aged \u2265\u00a075\u00a0years who underwent first esophageal or gastric ESD. Frailty was defined using the Hospital Frailty Risk Score (HFRS), calculated from diagnoses during a 2\u00a0year lookback period. After 1:1 propensity score matching, frail and non-frail patients were compared. The primary outcome was binary composite of short-term adverse events, including in-hospital perforation\/peritonitis, delayed bleeding, thromboembolism, aspiration pneumonia, and 30\u00a0day all-cause mortality. Component outcomes, survival, length of stay, costs, and readmission were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 15,184 eligible patients, 4,970 matched pairs were included. Frailty was associated with the composite adverse outcome (adjusted odds ratio 1.35; 95% confidence interval 1.19\u20131.53), driven mainly by perforation\/peritonitis and delayed bleeding. No significant differences were observed for 30\u00a0day mortality, thromboembolic events, or aspiration pneumonia. Frailty was also associated with lower overall survival during follow-up, whereas median length of stay was identical between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among older adults undergoing esophageal or gastric ESD, HFRS-defined claims-based frailty was associated with higher rates of short-term adverse events, particularly perforation\/peritonitis and delayed bleeding. These findings suggest that routinely collected claims data may help identify vulnerable patients who warrant closer peri-procedural assessment and monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00535-026-02526-x","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:14:42Z","timestamp":1792761282000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Claims-based frailty and short-term adverse events after esophageal or gastric endoscopic submucosal dissection in older adults"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6184-2215","authenticated-orcid":false,"given":"Hiroyuki","family":"Hisada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Tsuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Kakushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai","family":"Kubota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroya","family":"Mizutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Ohki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Takeuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichi","family":"Yakabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Niimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutake","family":"Yamamichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Fujishiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"2526_CR1","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1111\/den.13654","volume":"32","author":"R Ishihara","year":"2020","unstructured":"Ishihara R, Arima M, Iizuka T, et al. 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