Frailty Score Predicts Surgical Outcomes in the Elderly
(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 in JAMA Surgery.
Sun-wook Kim, MD, 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–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% of patients (29) experienced at least one complication after surgery and 24 (8.7%) 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 vs. ≤5, the model had a sensitivity and specificity for predicting all-cause mortality rates of 84.0 and 69.2%, 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.