Level of frailty predicts surgical outcomes
A simple, 10-minute “frailty” test administered to older patients before they undergo surgery can predict with great certainty their risk for complications, how long they will stay in the hospital and – most strikingly – whether they are likely to end up in a nursing home afterward.
In a study reported online and in an issue of the Journal of the American College of Surgeons, Dr Martin Makary, an Associate Professor of surgery at the United States Johns Hopkins University School of Medicine and his team applied the frailty test to 594 patients over age 65 who had elective surgery between July 2005 and July 2006.
Results showed that patients who were frail were 2.5 times as likely as those who were not to suffer a postoperative complication, 1.5 times as likely to spend more time in the hospital and 20 times as likely to be discharged to a nursing home or assisted living facility after previously living at home.
Previous research has also linked frailty to poor outcomes even in patients not undergoing surgery and has associated frailty with mortality, morbidity, falls and increased hospitalisation.
Dr Makary says frailty is a relatively new clinical concept and is best defined as someone’s physical reserve and ability to withstand stress to the body. Many patients considered medically healthy can be frail.
Approximately half of all operations in the United States are performed in patients over 65.
“Some surgeries are absolutely required no matter the risks and other surgeries are elective,” Dr Makary says.
“A good frailty test can help patients and surgeons make more informed decisions.”
