Key result
Frail surgical patients older than 78 years with an Operative Severity Score greater than 3 had a 39-fold increased risk of postsurgical loss of independence.
Why the study?
The study was aimed to determine the impact of preoperative frailty assessment screening on postoperative morbidity and postoperative loss of independence in elderly surgical patients.
Does preoperative frailty assessment predict postoperative loss of independence and mortality in elderly surgical patients?
Cross-Sectional (n=100)
No
Does preoperative frailty assessment predict postoperative loss of independence and mortality in elderly surgical patients?
Effect estimate: 39-fold increased risk
Preoperative frailty assessment using the Edmonton Frail Scale and Operative Severity Score can identify elderly surgical patients at high risk for postoperative loss of independence and mortality.
May inform preoperative risk stratification in elderly surgical patients; leaves open whether frailty interventions preserve independence.
Objective: This study was aimed to determine preoperative frailty assessment screening on postoperative morbidity and postoperative loss of independence (LOI). Materials & Methods: A total of 100 patient’s age 65 years and older were included in this study. Edmodium Frail Scale (EFS) was used for the assessment of frailty. The surgical procedure was categorized on operative severity score, and Hierarchical Condition Category (HCC). The Chi-square test was applied to see the significant/insignificant differences between different stratified groups of patients. Results: The mean age of the patients was 68 years. There were 63% male and 37% female patients. Maximum patients (78%) who had no LOI were in age less than 80 years. 11% of patients who had LOI were only 11%. There existed a significant difference (p-value: 0.004) between age groups (greater than/less than 80 years) of patients and presence/absence of loss of independence (LOI). After EFS assessment, 32% of patients had limited mobility, 22% had weight loss, 19% reported depression, 9% of patients were socially dependent and 18% reported cognitive impairment. Conclusion: The results suggest that frail patients older than 78 years and OSS > 3 had a more increased risk of postsurgical LOI. The patients with EFS >5 and OSS >3 had more LOI. EFS analysis explained that those patients with restricted mobility, depression, and dependent socially had increased LOI.
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DIN et al. (2021) conducted a cross-sectional in Elderly surgical patients (n=100). Preoperative frailty (EFS > 5) and high operative severity (OSS > 3) vs. Non-frail or lower operative severity was evaluated on Postoperative loss of independence (LOI) (39-fold increased risk). Frail surgical patients older than 78 years with an Operative Severity Score greater than 3 had a 39-fold increased risk of postsurgical loss of independence.
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