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01-12-2018 | Original Scientific Report

A Comparison of Two Preoperative Frailty Models in Predicting Postoperative Outcomes in Geriatric General Surgical Patients

Authors: Alexandros Andreou, Konstantinos Lasithiotakis, Maria Venianaki, Sofia Xenaki, Grigorios Chlouverakis, Ioannis Petrakis, Georgios Chalkiadakis

Published in: World Journal of Surgery | Issue 12/2018

Abstract

Background

Frailty in a surgical geriatric population may identify patients at increased risk of complications. However, the optimal method to diagnose it remains to be identified. This study aims to compare two common frailty models and assess their association with postoperative adverse outcomes in elderly patients undergoing general surgical procedures.

Methods

Prospective study including 298 patients age 65 years or older undergoing elective general surgical operations in a tertiary hospital. Frailty phenotype (FP) was classified using a validated scale which included weight loss, weakness, exhaustion, slowed walking speed and low physical activity. A preoperative comprehensive geriatric assessment (CGA) was performed including managing daily activities (ADL), instrumental ADL, cognitive status, comorbidities, polypharmacy and nutritional status. Main outcomes measures were postoperative complications and length of stay.

Results

There were 135 (46%), 114 (38%) and 46 (15%) minor/intermediate, major and major + procedures, respectively. The agreement between the FP and CGA was moderate (kappa index: 0.45). FP was significantly associated with postoperative complications with an odds ratio (OR) of 2.3, (95% confidence interval 1.4–3.8, p < 0.01). The association of CGA with postoperative complications did not reach statistical significance (p = 0.07). Postoperative hospital stay was significantly longer in both CGA frailty (p < 0.001) and FP (p = 0.001) groups compared to the fit population. In the multivariate analysis adjusted for ASA and POSSUM category, FP retained its significance as a predictor of postoperative complications (OR: 1.9, 95% CI 1.03–3.3, p = 0.038).

Conclusions

FP was associated more consistently than CGA with adverse postoperative outcomes in elderly patients undergoing general surgical procedures.

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Title: A Comparison of Two Preoperative Frailty Models in Predicting Postoperative Outcomes in Geriatric General Surgical Patients
Authors: Alexandros Andreou
Konstantinos Lasithiotakis
Maria Venianaki
Sofia Xenaki
Grigorios Chlouverakis
Ioannis Petrakis
Georgios Chalkiadakis
Publication date: 01-12-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 12/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4734-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A Comparison of Two Preoperative Frailty Models in Predicting Postoperative Outcomes in Geriatric General Surgical Patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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