title: Simple frailty score predicts postoperative complications across surgical specialties.
abstract: BACKGROUND
  Our purpose was to determine the relationship between preoperative frailty and the occurrence of postoperative complications after colorectal and cardiac operations.
  
  
  METHODS
  Patients 65 years or older undergoing elective colorectal or cardiac surgery were enrolled. Seven baseline frailty traits were measured preoperatively: Katz score less than or equal to 5, Timed Up and Go test greater than or equal to 15 seconds, Charlson Index greater than or equal to 3, anemia less than 35%, Mini-Cog score less than or equal to 3, albumin less than 3.4 g/dL, and 1 or more falls within 6 months. Patients were categorized by the number of positive traits as follows: nonfrail: 0 to 1 traits, prefrail: 2 to 3 traits, and frail: 4 or more traits.
  
  
  RESULTS
  Two hundred one subjects (age 74 ± 6 years) were studied. Preoperative frailty was associated with increased postoperative complications after colorectal (nonfrail: 21%, prefrail: 40%, frail: 58%; P = .016) and cardiac operations (nonfrail: 17%, prefrail: 28%, frail: 56%; P < .001). This finding in both groups was independent of advancing age. Frail individuals in both groups had longer hospital stays and higher 30-day readmission rates. Receiver operating characteristic curves examining frailty's ability to forecast complications were colorectal (.702, P = .004) and cardiac (.711, P < .001).
  
  
  CONCLUSIONS
  A simple preoperative frailty score defines older adults at higher risk for postoperative complications across surgical specialties.
authors.affiliation: Department of Surgery, University of Colorado at Denver School of Medicine, 12631 East 17th Ave, MS C313, Aurora, CO 80045, USA; Department of Surgery, Denver Veteran's Affairs Medical Center, Denver, CO, USA. Electronic address: thomas.robinson@ucdenver.edu.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Robinson
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Wu
authors.forename: Lauren
authors.initials: L
authors.lastname: Pointer
authors.forename: Christina L
authors.initials: CL
authors.lastname: Dunn
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cleveland
authors.forename: Marc
authors.initials: M
authors.lastname: Moss
mesh_terms: D000368:Aged; D013504:Cardiovascular Surgical Procedures; D003106:Colon / Q000601:surgery; D013505:Digestive System Surgical Procedures; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011446:Prospective Studies; D012372:ROC Curve; D012007:Rectum / Q000601:surgery; D018570:Risk Assessment
keywords: Geriatric surgery; Preoperative risk assessment; Surgical morbidity