Document Detail


Are the frail destined to fail? Frailty index as predictor of surgical morbidity and mortality in the elderly.
MedLine Citation:
PMID:  22695416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: America's aging population has led to an increase in the number of elderly patients necessitating emergency general surgery. Previous studies have demonstrated that increased frailty is a predictor of outcomes in medicine and surgical patients. We hypothesized that use of a modification of the Canadian Study of Health and Aging Frailty Index would be a predictor of morbidity and mortality in patients older than 60 years undergoing emergency general surgery.
METHODS: Data were obtained from the National Surgical Quality Improvement Program Participant Use Files database in compliance with the National Surgical Quality Improvement Program Data Use Agreement. We selected all emergency cases in patients older than 60 years performed by general surgeons from 2005 to 2009. The effect of increasing frailty on multiple outcomes including wound infection, wound occurrence, any infection, any occurrence, and mortality was then evaluated.
RESULTS: Total sample size was 35,334 patients. As the modified frailty index increased, associated increases occurred in wound infection, wound occurrence, any infection, any occurrence, and mortality. Logistic regression of multiple variables demonstrated that the frailty index was associated with increased mortality with an odds ratio of 11.70 (p < 0.001).
CONCLUSION: Frailty index is an important predictive variable in emergency general surgery patients older than 60 years. The modified frailty index can be used to evaluate risk of both morbidity and mortality in these patients. Frailty index will be a valuable preoperative risk assessment tool for the acute care surgeon. Level of Evidence: Prognostic study, level II.
Authors:
Joseph S Farhat; Vic Velanovich; Anthony J Falvo; H Mathilda Horst; Andrew Swartz; Joe H Patton; Ilan S Rubinfeld
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  72     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-14     Completed Date:  2012-09-04     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1526-30; discussion 1530-1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 by Lippincott Williams & Wilkins
Affiliation:
Department of Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cause of Death*
Cohort Studies
Databases, Factual
Female
Follow-Up Studies
Frail Elderly / statistics & numerical data*
Geriatric Assessment / methods
Hospital Mortality / trends*
Humans
Logistic Models
Male
Odds Ratio
Postoperative Complications / mortality*,  physiopathology
Predictive Value of Tests
Quality Improvement
Retrospective Studies
Risk Assessment
Surgical Procedures, Operative / adverse effects,  methods,  mortality*
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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