Long-term influence of frailty in elderly patients after surgical emergencies
| Autor: | Ana Rovira Liarde, Gregorio Anguiano Díaz, Alejandro Sánchez Arteaga, Felipe Pareja Ciuró, Luis Tallón Aguilar, Javier Padillo Ruíz, R. M. Jimenez-Rodriguez, José Tinoco González |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Frail Elderly Critical Care and Intensive Care Medicine Logistic regression Risk Assessment Postoperative Complications Risk Factors Internal medicine medicine Humans Orthopedics and Sports Medicine Prospective Studies Risk factor Prospective cohort study Geriatric Assessment Survival analysis Aged Frailty business.industry Mortality rate Hazard ratio Triage Confidence interval Emergency Medicine Female Surgery Emergencies business |
| Zdroj: | European Journal of Trauma and Emergency Surgery. 48:3855-3862 |
| ISSN: | 1863-9941 1863-9933 |
| DOI: | 10.1007/s00068-021-01818-6 |
| Popis: | Purpose Frailty is known to increase vulnerability to stressful factors, and motivate a higher morbidity and mortality in several health conditions. However, long-term impact of frailty after surgical procedures remains unclear. The purpose of this study was to evaluate the relationship between frailty and long-term clinical outcomes after emergency surgery. Methods Prospective cohort study in patients older than 70 years undergoing emergency procedures. A total of 82 patients (mean age 78.5 years, 53.3% women) were consecutively enrolled. Data on demographics, surgical procedures, complications after 30 postoperative days, and frailty according to the clinical frailty scale, Triage Risk Screening Tool (TRST), and FRAIL scale were recorded. Readmission, mortality, and transition to frailty rates were analyzed at 6 and 18 months postoperatively. Results The prevalence of frailty ranged between 14.6 and 29.6% depending on the scale used. The overall mortality rate at 18 months was 19.5% (16 patients), and the survival curves demonstrated a significant difference in mortality between frail and non-frail patients assessed using the FRAIL scale and TRST (p = 0.049 and p = 0.033, respectively), with a hazard ratio of 2.28 (95% confidence interval 1.24-6.44). Logistic regression analysis showed that diabetes (p = 0.013) was an independent risk factor for transition to frailty, and antidepressant drug use was close to statistical significance (p = 0.08). Conclusion Frailty is a predictive marker of long-term mortality in patients undergoing emergency procedures. Diabetes and depression may represent independent risk factors for transition to frailty over time. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink