title: Frailty predicts increased hospital and six-month healthcare cost following colorectal surgery in older adults.
abstract: BACKGROUND
  The purpose of this study was to determine the relationship of frailty and 6-month postoperative costs.
  
  
  METHODS
  Subjects aged ≥ 65 years undergoing elective colorectal operations were enrolled in a prospective observational study. Frailty was assessed by a validated measure of function, cognition, nutrition, comorbidity burden, and geriatric syndromes. Frailty was quantified by summing the number of positive characteristics in each subject.
  
  
  RESULTS
  Sixty subjects (mean age, 75 ± 8 years) were studied. Inpatient mortality was 2% (n = 1). Overall, 40% of subjects (n = 24) were considered nonfrail, 22% (n = 13) were prefrail, and 38% (n = 22) were frail. With advancing frailty, hospital costs increased (P < .001) and costs from discharge to 6-months increased (P < .001). Higher degrees of frailty were related to increased rates of discharge institutionalization (P < .001) and 30-day readmission (P = .044).
  
  
  CONCLUSIONS
  A simple, brief preoperative frailty assessment accurately forecasts increased surgical hospital costs and postdischarge to 6-month healthcare costs after colorectal operations in older adults.
authors: Department of Surgery, Denver Veterans Affairs Medical Center, Denver, CO, USA. thomas.robinson@ucdenver.edu
authors: Thomas N
authors: TN
authors: Robinson
authors: Daniel S
authors: DS
authors: Wu
authors: Gregory V
authors: GV
authors: Stiegmann
authors: Marc
authors: M
authors: Moss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000191:economics*; D005260:Female; D016330:Frail Elderly; D017048:Health Care Costs; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007326:Institutionalization / Q000191:economics; D008297:Male; D010351:Patient Discharge; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D014481:United States