Our results confirmed that high composite risk index, a combination of mFI (≥0.27), malnutrition, moderate to severe anemia (hemoglobin < 90 g/L), and severe hypoalbuminemia (albumin ≤30 g/L), was an independent predictor for increased risk of POCs in older patients recovering from elective digestive tract surgery. Here, ALB is linked to malnutrition.