Frailty Index as a Predictor of Perioperative Outcomes Undergoing Elective Surgeries

This is the authors' abstract. We don't add key points for this paper.

Background and Objectives: A hospitalised older surgical patient is faced with many challenges during their phases of peri-operative period. Apart from surgery, there are many factors which can cause a huge impact on their frail body systems, which includes fasting, intra-operative blood loss, anaesthetic drugs, opioid analgesics, postoperative nausea and vomiting, the hospital environment and immobility during peri-operative period. In our study, we used Modified Frailty Index (MFI) 5 to assess frailty. Methods: A total of 155 elderly patients above 65 years of age undergoing elective noncardiac surgery were taken into consideration. The study was divided into three phases: preoperative, intraoperative and postoperative periods. All Relevant Patient Demographic Details: Age, gender, weight, height and all available preoperative investigations were taken from the case sheet. Charleston Comorbidity Index (CCI) and Clinical Frailty Score (CFS) scoring were done. Intraoperative Period: Total anaesthesia and operative time, Anaesthesia technique, Any Difficult airway/difficult regional anaesthesia, Total fluids given/Urine output, Blood transfusions/Blood loss, Total Opioid used, any delayed awakening, any metabolic derangements, any cardiorespiratory event, Total recovery time - Time to awakening were noted. Postoperative period: Postoperative Nausea and Vomiting (PONV), Visual Analogue Scale (VAS), Richmond Agitation Sedation Score (RASS), Admission to the Intensive Care Unit (ICU), Duration of hospital stay, UB-2, Duration of stay, Modified Aldrete Score were done. Results: In our study analysis, it was seen that the higher the frailty, higher is ASA category 2 and 3. It also showed that frail people had low Hb. Our study had majority of males undergoing minor surgeries under general anaesthesia. The rest of the variables taken for the comparison was insignificant. Conclusion: It was shown that MFI 5 was a sensitive indicator for the assessment of frailty, though other indices like CFS, MFI 1 are also used.