Frailty is associated with postoperative complications in older adults with medical problems

Arch Gerontol Geriatr. Jan-Feb 2009;48(1):78-83. doi: 10.1016/j.archger.2007.10.007. Epub 2008 Feb 20.

Abstract

We sought to test whether frailty may be predictive of operative risk in older adults with medical problems. One hundred and twenty-five patients at least 70 years of age had a previously developed frailty screen, the Edmonton Frail Scale (EFS), administered at a pre-surgical clinic, prior to elective non-cardiac surgery. A blinded chart audit assessed for postoperative medical complications, length of stay and inability to be discharged home. The mean age of patients was 77 (range 70-92) and most (82%) underwent orthopedic procedures. Increasing frailty was associated with postoperative complications (p=0.02), increased length of hospitalization (p=0.004) and inability to be discharged home (p=0.01), independent of age. EFS scores of 3 or less were associated with a lower risk of having a complication (age-adjusted OR 0.27, 95% CI 0.09-0.80, likelihood ratio of 0.33) and a higher chance (80%) of being discharged home (p<0.02). EFS scores exceeding 7 were associated with increased complications (OR 5.02, 95% CI 1.55-16.25, likelihood ratio of 3.9) and a lower chance of being discharged home (40%, p<0.02). This study suggests that a frailty screen can refine risk estimates of postoperative complications in older adults undergoing elective non-cardiac surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity / trends
  • Elective Surgical Procedures / adverse effects*
  • Female
  • Follow-Up Studies
  • Frail Elderly*
  • Humans
  • Incidence
  • Length of Stay
  • Male
  • Ontario / epidemiology
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Preoperative Care / methods
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate