Key result
Abnormal frailty screening using TUG and CDT was associated with higher rates of postoperative delirium (19% vs 3%, p=0.011 for TUG; 17% vs 2%, p=0.019 for CDT) in older elective surgery patients.
Why the study?
There is a need for a feasible tool to assess frailty risk before surgery.
Do frailty screening tools (PRISMA7, TUG, CDT) predict adverse postoperative outcomes in patients ≥65 years undergoing elective surgery?
Cohort (n=99)
Do frailty screening tools (PRISMA7, TUG, CDT) predict adverse postoperative outcomes in patients ≥65 years undergoing elective surgery?
Frailty screening tools (PRISMA7, TUG, CDT) frequently identify abnormalities in older surgical patients and are associated with an increased risk of adverse postoperative outcomes such as delirium and non-home discharge.
BACKGROUND: There is a need for a feasible tool to assess the risk of frailty prior to surgery. We aimed to identify the ratio of abnormal results for three clinically applicable screening tools to assess the risk of frailty, and their association with adverse outcomes in a cohort of elderly surgical patients. METHODS: In this prospective pilot study, patients ≥65 years undergoing preoperative evaluation for elective surgery were included and subjected to three frailty screening tests; Program of Research to Integrate Services for the Maintenance of Autonomy 7-item questionnaire (PRISMA7), Timed Up and Go (TUG), and Clock Drawing Test (CDT). The primary outcome was the incidence of abnormal testing, and secondary outcomes were the association between abnormal tests and mortality, readmission, delirium, surgical complications and non-home discharge. RESULTS: Out of 99 patients, 41%, 37%, and 43% had abnormal PRISMA7, TUG, and CDT screening, respectively. Postoperative delirium was more likely to occur in patients with abnormal TUG screening (19% vs. 3%, p = .011) and CDT (17% vs. 2%, p = .019). When analyzing screening tool combinations, patients with abnormal PRISMA7 and TUG had a higher rate of non-home discharge (38% vs. 17%, p = .029); and patients with abnormal TUG and CDT had a higher rate of postoperative delirium (25% vs. 3%, p = .006) and any surgical complication (58% vs. 38%, p = .037); and patients with abnormal results from all three tools had a higher rate of postoperative delirium (21% vs. 5%, p = .045) and non-home discharge (42% vs. 18%, p = .034). CONCLUSION: Approximately 40% of elderly surgical patients have abnormal PRISMA7, TUG, and CDT screening tests for frailty, and they are associated individually or in combination with increased risk of adverse postoperative outcomes. The results will aid in designing studies to further risk-stratify patients at risk of frailty and attempt to modify associated outcomes.
No takes yet. Share an insight, caveat, or question.
Rabelo et al. (2022) conducted a cohort in Elective surgery in elderly patients (n=99). Abnormal frailty screening (PRISMA7, TUG, CDT) vs. Normal frailty screening was evaluated on Incidence of abnormal testing. Abnormal frailty screening using TUG and CDT was associated with higher rates of postoperative delirium (19% vs 3%, p=0.011 for TUG; 17% vs 2%, p=0.019 for CDT) in older elective surgery patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: