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Frail Patients Undergoing Optimization Before Surgery: Preliminary Results.

Authors :
Hui, Lauren T.
St Pierre, Diane
Miller, Richard S.
Source :
Journal of the American College of Surgeons (2563-9021). Apr2024, Vol. 238 Issue 4, p577-588. 12p.
Publication Year :
2024

Abstract

BACKGROUND: It is estimated that 10% or more of patients older than 65 years are affected by frailty, a mental and physical state of vulnerability to adverse surgical outcomes. Frailty can be assessed using the Edmonton Frailty Scale: a reliable and convenient multidimensional assessment before surgery. The correlation between frailty score, presurgical optimization, and surgical outcomes was investigated in this preliminary pilot study. STUDY DESIGN: A retrospective study was performed on patients referred to the surgical optimization clinic and assessed for frailty from September 2020 to May 2023. Patients received presurgical optimization for reasons including diabetes, smoking cessation, prehabilitation and nutrition, and/or cardiopulmonary issues. Outcomes were evaluated whether they proceeded to surgery, were referred to the High-Risk Surgical Committee, surgical case canceled, or not scheduled. For those who proceeded to surgery, infection rates, complications, and 30-day emergency department (ED) and readmission rates were evaluated. RESULTS: Of 143 unique patients, 138 (men = 61, women = 77) were evaluated for this study. The average Edmonton frailty score for patients who proceeded to surgery was 7.013 (n = 78) vs 9.389 with cancelation and 9.600 for not scheduled or not optimized for surgery. Postoperative infection rates were <3%. However, 30-day ED and readmission rate was 21% (16 of 78). CONCLUSIONS: Patients with lower average Edmonton frailty scores were more likely to proceed to surgery, whereas those with higher average Edmonton frailty scores were more likely to have surgery canceled or delayed. Frail patients cleared for surgery were found to have a high 30-day ED and readmission rate. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
25639021
Volume :
238
Issue :
4
Database :
Academic Search Index
Journal :
Journal of the American College of Surgeons (2563-9021)
Publication Type :
Academic Journal
Accession number :
176855462
Full Text :
https://doi.org/10.1097/XCS.0000000000000965