What question did this study set out to answer?

This study aims to evaluate the relationship between geriatric assessment markers and 6-month postoperative mortality in elderly surgical patients.

August 28, 2009Annals of Surgery

Redefining Geriatric Preoperative Assessment Using Frailty, Disability and Co-Morbidity

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Why the study?

Do preoperative geriatric assessment markers predict 6-month mortality in elderly patients undergoing major surgery?

Population

110 subjects ≥65 years undergoing a major operation requiring postoperative intensive care unit admission.

Design

Cohort

Follow-up

6 months

Authors

TRThomas N. RobinsonPreventive Cardiology BEBen EisemanUniversity of Colorado Hospital JWJeffrey I. WallaceUniversity of Colorado Denver

Discussion

Member takes

Implication

Functional dependence may aid preoperative risk stratification in elderly surgical patients; hypothesis-generating and should not yet change practice.

Key Points

This study aims to evaluate the relationship between geriatric assessment markers and 6-month postoperative mortality in elderly surgical patients.
Prospective enrollment of subjects aged 65 years and older undergoing major surgery needing postoperative ICU admission.
Preoperative assessments included cognitive tests, albumin levels, fall history, hematocrit, functional assessments, and comorbidity index.
Outcome measures focused on 6-month mortality and postdischarge institutionalization.
Six-month mortality was 15% (16 out of 110 subjects) and was associated with several preoperative markers.
Impaired cognition, recent falls, lower albumin, greater anemia, functional dependence, and higher comorbidities each predicted increased mortality (all P < 0.01).
Having four or more geriatric markers predicted 6-month mortality with an 81% sensitivity and 86% specificity.

Structured PICO

Do preoperative geriatric assessment markers predict 6-month mortality in elderly patients undergoing major surgery?

Population

110 subjects ≥65 years (mean age 74 ± 6 years) undergoing a major operation requiring postoperative intensive care unit admission.

Intervention

Preoperative geriatric assessment using 6 markers: Mini-Cog Test (cognition), albumin, having fallen in the past 6-months, hematocrit, Katz Score (function), and Charlson Index (comorbidities).

Outcome

6-month mortalityhard clinical

Preoperative assessment using geriatric-specific markers for frailty, disability, and comorbidity strongly predicts 6-month mortality and institutionalization in elderly surgical patients.

Cite This Study

Robinson et al. (2009) studied this question.

synapsesocial.com/papers/69fd180637bfdcfbd7509726 https://doi.org/10.1097/sla.0b013e3181b45598

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Implication

Functional dependence may aid preoperative risk stratification in elderly surgical patients; hypothesis-generating and should not yet change practice.

Redefining Geriatric Preoperative Assessment Using Frailty, Disability and Co-Morbidity

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Redefining Geriatric Preoperative Assessment Using Frailty, Disability and Co-Morbidity

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider