Frailty is an aggregate of medical and geriatric conditions that affect elderly and vulnerable
patients; as frailty is known to affect postoperative outcomes, we evaluate the effects of frailty
in patients undergoing esophageal resection surgery for esophageal cancer. 2011–2017
National Inpatient Sample was used to isolate younger (18 to< 65) and older (65 or greater)
patients undergoing esophagectomy for esophageal cancer, substratified using frailty
(defined by Johns-Hopkins ACG frailty indicator) into frail patients and non-frail controls; the …

The authors reported above 50% of oesophagectomies were performed for benign disease.
Based on previously reported data we would expect benign esophageal resections to be in
the region of 2%–3%. 2, 3 We therefore question how confident the authors are in the use of
their coding for surgery. For example,'Excision of Lower Esophagus, Via Natural or Artificial
Opening,'. We welcome comments on whether this could lead to incorrect inclusion of
endoscopic biopsies and mucosal resections rather than oesophagectomy alone? We also …