Frailty Score Predicts Surgical Outcomes in the Elderly

Posted on Sun, Jun 01, 2014
Frailty Score Predicts Surgical Outcomes in the Elderly

Score includes comprehensive geriatric assessment features and is better than conventional measures

WEDNESDAY, May 14, 2014 (HealthDay News) -- A multidimensional frailty score composed of comprehensive geriatric assessments is more useful than conventional methods for predicting surgery outcomes, including all-cause mortality, in older patients, according to a study published online May 7 inJAMA Surgery.

Sun-wook Kim, M.D., from the Seoul National University College of Medicine in South Korea, and colleagues assessed outcomes in 275 consecutive elderly patients (aged ≥65 years) undergoing intermediate-risk or high-risk elective operations (Oct. 19, 2011, to July 31, 2012).

The researchers found that 25 patients died during a median 13.3 months of follow-up. Four of these deaths occurred in the hospital. More than 10 percent of patients (29) experienced at least one complication after surgery and 24 (8.7 percent) were discharged to nursing facilities. Rates of all-cause mortality were predicted more accurately by a multidimensional frailty score model (composed of Charlson Comorbidity Index, dependence in activities of daily living, dependence in instrumental activities of daily living, dementia, risk of delirium, short mid-arm circumference, and malnutrition), compared to the American Society of Anesthesiologists classification (P = 0.01). Using a cut-off point of >5 versus ≤5, the model had a sensitivity and specificity for predicting all-cause mortality rates of 84.0 and 69.2 percent, respectively.

"The multidimensional frailty score based on comprehensive geriatric assessment is more useful than conventional methods for predicting outcomes in geriatric patients undergoing surgery," the authors write.

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