Can a 'Frailty Score' Predict Surgical Outcomes?
Can a 'Frailty Score' Predict Surgical Outcomes?
Revenig LM, Canter DJ, Taylor MD, et al
J Am Coll Surg. 2013;217:665.e.1-670.e.1
The aim of this report was to provide quantitative information about the likelihood of a frail patient developing a postoperative complication. The assessment tool was the Hopkins Frailty Score, and it was evaluated in 189 patients undergoing urologic, oncologic, or general surgical procedures. Mean age of patients was 62 years, and 50 patients (26%) were scored as frail.
Eighty-five complications developed in 73 patients, with complications twice as frequent in the group of frail or intermediately frail patients. The 3 postoperative deaths occurred in the frail patients.
Preoperative evaluation of risk assessment is often subjective. Surgeons and anesthesiologists have their own preferred methods of patient evaluation, many of which are organ-specific. This report describes a scoring system based on several components: unintentional weight loss, weakness measured by hand strength, self-described exhaustion, decreased leisure-time activities, and reduced walking speed.
One advantage of this scoring instrument is that the individual components can be measured relatively easily and inexpensively. As the number of elderly patients requiring surgical care increases, accurate assessment of risk will become increasingly important.
Abstract
Too Frail for Surgery? Initial Results of a Large Multidisciplinary Prospective Study Examining Preoperative Variables Predictive of Poor Surgical Outcomes
Revenig LM, Canter DJ, Taylor MD, et al
J Am Coll Surg. 2013;217:665.e.1-670.e.1
Summary
The aim of this report was to provide quantitative information about the likelihood of a frail patient developing a postoperative complication. The assessment tool was the Hopkins Frailty Score, and it was evaluated in 189 patients undergoing urologic, oncologic, or general surgical procedures. Mean age of patients was 62 years, and 50 patients (26%) were scored as frail.
Eighty-five complications developed in 73 patients, with complications twice as frequent in the group of frail or intermediately frail patients. The 3 postoperative deaths occurred in the frail patients.
Viewpoint
Preoperative evaluation of risk assessment is often subjective. Surgeons and anesthesiologists have their own preferred methods of patient evaluation, many of which are organ-specific. This report describes a scoring system based on several components: unintentional weight loss, weakness measured by hand strength, self-described exhaustion, decreased leisure-time activities, and reduced walking speed.
One advantage of this scoring instrument is that the individual components can be measured relatively easily and inexpensively. As the number of elderly patients requiring surgical care increases, accurate assessment of risk will become increasingly important.
Abstract
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