Impact of frailty in surgical emergencies. A comparison of four frailty scales.

Autor: Arteaga AS; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain. alejandros.arteaga@gmail.com., Aguilar LT; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain., González JT; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain., Boza AS; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain., Muñoz-Cruzado VD; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain., Ciuró FP; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain., Ruíz JP; Universitary Hospital Virgen del Rocío, Avenida Manuel Siurot, 41013, Seville, Spain.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2021 Oct; Vol. 47 (5), pp. 1613-1619. Date of Electronic Publication: 2020 Feb 08.
DOI: 10.1007/s00068-020-01314-3
Abstrakt: Introduction: Frailty is a geriatric syndrome, leading to declines in homeostatic reserve and physical resistance. It has been considered as a risk factor for falls, fractures, need of institutionalization, length of stay and mortality. Our aim was to evaluate the relationship between frailty, 30-day postoperative mortality and morbidity, for elderly patients undergoing surgical emergencies.
Material and Methods: Prospective, observational cohort Study (September 2017-April 2019), using four different frailty scales (Clinical Frailty Scale, FRAIL scale, TRST and Share-FI) as a risk factor of 30-day postoperative outcomes, for patients older than 70 years undergoing emergency surgery. We analyzed diagnoses, clinical examination at admission, surgical procedures, and postoperative outcomes during the first 30 days or until discharge.
Results: 92 patients were included, with a mean age was 78.7 years (SD 6.3). Frailty prevalence varied since 14.1% obtained using FRAIL scale, to 25%, 29.2% and 30.4%, from Clinical Frailty Scale, TRST and Share-FI, respectively. All four frailty scales show statistical differences to predict major complication and mortality in our sample. FRAIL scale showed the highest sensitivity-specificity pair to predict mortality in our sample (AUC = 0.870). TRST and FRAIL scales showed the strongest measure of association (OR 7.69 and 5.92, respectively) for major complications. Regarding need for admission to the ICU, hospital stay or reoperation rate, only FRAIL scale showed a statistically significant association.
Conclusion: Frailty represents a predictive marker of mortality and major complications, in surgical emergencies. FRAIL score, shows the strongest relationship with mortality and complications, compared to other frailty scales.
(© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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