Routine frailty assessment predicts postoperative complications in elderly patients across surgical disciplines - a retrospective observational study.

ABSTRACT: BACKGROUND:Frailty is a frequent and underdiagnosed functional syndrome involving reduced physiological reserves and an increased vulnerability against stressors, with severe individual and socioeconomic consequences. A routine frailty assessment was implemented at our preoperative anaesthesia clinic to identify patients at risk. OBJECTIVE:This study examines the relationship between frailty status and the incidence of in-hospital postoperative complications in elderly surgical patients across several surgical disciplines. DESIGN:Retrospective observational analysis. SETTING:Single center, major tertiary care university hospital. Data collection took place between June 2016 and March 2017. PATIENTS:Patients 65?years old or older were evaluated for frailty using Fried's 5-point frailty assessment prior to elective non-cardiac surgery. Patients were classified into non-frail (0 criteria, reference group), pre-frail (1-2 positive criteria) and frail (3-5 positive criteria) groups. MAIN OUTCOME MEASURES:The incidence of postoperative complications was assessed until discharge from the hospital, using the roster from the National VA Surgical Quality Improvement Program. Propensity score matching and logistic regression analysis were performed. RESULTS:From 1186 elderly patients, 46.9% were classified as pre-frail (n?=?556), and 11.4% as frail (n?=?135). The rate of complications were significantly higher in the pre-frail (34.7%) and frail groups (47.4%), as compared to the non-frail group (27.5%). Similarly, length of stay (non-frail: 5.0 [3.0;7.0], pre-frail: 7.0 [3.0;9.0], frail 8.0 [4.5;12.0]; p?

SUBMITTER: Birkelbach O 

PROVIDER: S-EPMC6839249 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature