Frailty is associated with postoperative complications in older adults with medical problems.
We sought to test whether frailty may be predictive of operative risk in older adults with medical problems. One hundred and twenty-five patients at least 70 years of age had a previously developed frailty screen, the Edmonton Frail Scale (EFS), administered at a pre-surgical clinic, prior to elective non-cardiac surgery. A blinded chart audit assessed for postoperative medical complications, length of stay and inability to be discharged home. The mean age of patients was 77 (range 70-92) and most (82%) underwent orthopedic procedures. Increasing frailty was associated with postoperative complications (p=0.02), increased length of hospitalization (p=0.004) and inability to be discharged home (p=0.01), independent of age. EFS scores of 3 or less were associated with a lower risk of having a complication (age-adjusted OR 0.27, 95% CI 0.09-0.80, likelihood ratio of 0.33) and a higher chance (80%) of being discharged home (p<0.02). EFS scores exceeding 7 were associated with increased complications (OR 5.02, 95% CI 1.55-16.25, likelihood ratio of 3.9) and a lower chance of being discharged home (40%, p<0.02). This study suggests that a frailty screen can refine risk estimates of postoperative complications in older adults undergoing elective non-cardiac surgery.
Dasgupta
Monidipa
M
Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine, University of Western Ontario, Room A3-125, St. Josephs Healthcare Centre, 268 Grosvenor Road, London, Ontario N6A 4V2, Canada. monidipa.Dasgupta@sjhc.london.on.ca
Rolfson
Darryl B
DB
Stolee
Paul
P
Borrie
Michael J
MJ
Speechley
Mark
M
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity / Q000639:trends; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate