title: Frailty is associated with postoperative complications in older adults with medical problems.
abstract: 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.
authors: 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
authors: Monidipa
authors: M
authors: Dasgupta
authors: Darryl B
authors: DB
authors: Rolfson
authors: Paul
authors: P
authors: Stolee
authors: Michael J
authors: MJ
authors: Borrie
authors: Mark
authors: M
authors: Speechley
mesh_terms: 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