Are the frail destined to fail? Frailty index as predictor of surgical morbidity and mortality in the elderly
| Autor: | Ilan Rubinfeld, Andrew Swartz, Joseph Farhat, H. Mathilda Horst, Vic Velanovich, Joe H. Patton, Anthony Falvo |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Population ageing Databases Factual Frail Elderly Critical Care and Intensive Care Medicine Risk Assessment Cohort Studies Postoperative Complications Predictive Value of Tests Cause of Death Odds Ratio medicine Humans Hospital Mortality Intensive care medicine Geriatric Assessment Survival analysis Aged Retrospective Studies Cause of death Aged 80 and over business.industry Retrospective cohort study Odds ratio Quality Improvement Survival Analysis Surgery Logistic Models Treatment Outcome Surgical Procedures Operative Predictive value of tests Female Risk assessment business Follow-Up Studies Cohort study |
| Zdroj: | Journal of Trauma and Acute Care Surgery. 72:1526-1531 |
| ISSN: | 2163-0755 |
| DOI: | 10.1097/ta.0b013e3182542fab |
| Popis: | 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.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.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 (p0.001).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.Prognostic study, level II. |
| Databáze: | OpenAIRE |
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