Preoperative frailty was associated with a significant reduction in 30-day postoperative disability (mean WHODAS change -2.66), whereas non-frail patients experienced no significant change.
Cohort (n=146)
No
Does preoperative frailty predict meaningful functional improvement in patients aged > 50 years undergoing elective surgery?
Preoperative frailty identifies patients with the greatest potential for short-term functional gain after elective surgery, though this benefit is significantly attenuated in patients over 75 years of age.
Effect estimate: OR 4.05
Absolute Event Rate: -2.66% vs 0.35%
p-value: p=0.167
Frailty is a known predictor of adverse surgical outcomes, yet its influence on functional recovery trajectories in South Asian settings remains underexplored. This study evaluated the association between preoperative frailty and achieving a clinically meaningful improvement in disability 30 days after elective surgery. A prospective cohort study was conducted at a tertiary hospital in Karachi, enrolling 146 patients aged > 50 years undergoing elective general or orthopedic surgery. Preoperative frailty was assessed using the Edmonton Frail Scale (EFS). Disability was measured using the WHODAS-12 at baseline and 30 days postoperatively. The primary outcome was a meaningful functional improvement, defined as a decrease of ≥ 3.5 points on the WHODAS-12 scale. Among 146 patients (mean age 64.1 ± 9.4 years), 76.7% (n = 112) were categorized as frail. Frail patients had significantly higher baseline disability than non-frail patients (17.74 ± 6.70 vs. 12.29 ± 7.84; p 75 years were 89% less likely to achieve improvement (OR 0.11; 95% CI: 0.01–0.98; p = 0.048). Subgroup analysis indicated that improvement rates peaked in the Moderate frailty category (47.62%) compared to those classified as Vulnerable (12.50%). Preoperative frailty identifies patients with the greatest potential for functional gain, though this recovery is significantly limited by advanced age. These results suggest that surgery provides a “functional dividend” for frail individuals with high baseline impairment. Routine frailty screening should be utilized to manage expectations and tailor recovery pathways in aging surgical populations.
Ahmed et al. (Mon,) conducted a cohort in Elective general or orthopedic surgery (n=146). Preoperative frailty vs. Non-frail was evaluated on Clinically meaningful functional improvement (≥3.5 point decrease in WHODAS-12 score) (OR 4.05, p=0.167). Preoperative frailty was associated with a significant reduction in 30-day postoperative disability (mean WHODAS change -2.66), whereas non-frail patients experienced no significant change.