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European Journal of Trauma and Emergency Surgery

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Open Access 02-02-2022 | Appendicitis | Original Article

Frailty in elderly patients with acute appendicitis

Authors: Alexander Reinisch, Martin Reichert, Christian Charles Ondo Meva, Winfried Padberg, Frank Ulrich, Juliane Liese

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2022

Abstract

Purpose

Acute appendicitis in the elderly is becoming increasingly recognized for its often severe course. For various elective and urgent operations in older patients, frailty is a risk factor for poor outcomes. However, there is a lack of data on frailty in elderly patients with acute appendicitis.

Methods

Patients over 65 years old who underwent surgery for acute appendicitis in three hospitals between January 2015 and September 2020 were assessed with the Hospital Frailty Risk Score (HFRS) and the modified Frailty Index (mFI). Outcomes of interest, including morbidity, mortality, and length of stay, were recorded.

Results

While frailty can be measured with both tests, the mFI has better applicability and takes significantly less time to implement compared to the HFRS (21.6 s vs. 80.3 s, p < 0.0001) while providing the same information value.

Patients who exhibited frailty according to either assessment had a significantly higher rate of milder (OR 5.85/2.87, p < 0.0001/0.009) and serious (OR 4.92/3.61, p < 0.011/0.029) complications, more admissions to the intensive care unit (OR 5.16/7.36, p < 0.0001), and an almost doubled length of stay (12.7 days vs. 6.6 days, p < 0.005). Up to 31% of these patients required institutional care after discharge, which is significantly more than those without frailty (p < 0.0001). Furthermore, the mortality rate in frail patients was significantly elevated to 17%, compared to less than 1% in non-frail patients (p = 0.018).

Conclusion

In elderly patients, frailty is a significant risk factor for negative outcomes. Frailty can be assessed more quickly and reliably with the mFI compared to the HFRS.

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Title: Frailty in elderly patients with acute appendicitis
Authors: Alexander Reinisch
Martin Reichert
Christian Charles Ondo Meva
Winfried Padberg
Frank Ulrich
Juliane Liese
Publication date: 02-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Appendicitis
Appendicitis
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01878-2

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Springer Medicine

Frailty in elderly patients with acute appendicitis

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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