Does frailty status increase the likelihood, rate, duration, and severity of intraoperative hypotension in older patients undergoing elective surgery?
Prefrail and frail older patients are at significantly higher risk for intraoperative hypotension during elective surgery compared to robust patients.
BACKGROUND: Frailty is a predictor of morbidity and mortality in older patients. This study aimed to investigate the influence of frailty status on likelihood, rate, duration, and severity of intraoperative hypotension (IOH), which can lead to severe organ dysfunction. METHODS: Surgical patients (≥70 yr old) with preoperative frailty assessment were analysed retrospectively. Frailty status was defined as robust, prefrail, or frail based on modified Fried criteria. IOH was defined as mean arterial pressure 90% after considering number of measured blood pressures and surgical duration and >70% after accounting for total propofol dose. CONCLUSIONS: Prefrail and frail patients aged ≥70 yr experienced up to 16% more IOH during surgery and 28% more during anaesthesia induction compared with robust patients. Preoperative optimisation (prehabilitation) and modification of intraoperative management (e.g. invasive blood pressure management) have the potential to reduce IOH in prefrail and frail patients.
Daum et al. (Fri,) studied this question.