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...

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Bibliographic Details
Published in:Archives of gerontology and geriatrics 2009-01, Vol.48 (1), p.78-83
Main Authors: Dasgupta, Monidipa, Rolfson, Darryl B, Stolee, Paul, Borrie, Michael J, Speechley, Mark
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Co-morbidity
Comorbidity - trends
Complications
Elective surgery
Elective Surgical Procedures - adverse effects
Female
Follow-Up Studies
Frail
Frail Elderly
Frailty
Humans
Incidence
Internal Medicine
Length of Stay
Male
Ontario - epidemiology
Postoperative complications
Postoperative Complications - diagnosis
Postoperative Complications - epidemiology
Postoperative Complications - prevention & control
Postoperative morbidity
Preoperative care
Preoperative Care - methods
Prognosis
Retrospective Studies
Risk Factors
Sick elderly people
Survival Rate
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Summary: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.
ISSN:0167-4943
1872-6976
DOI:10.1016/j.archger.2007.10.007