Association of preop frailty assessment with 1-year postop mortality

Editor's Note

This study from the University of Pittsburgh finds that preoperative frailty screening was associated with significantly reduced 1-year postoperative mortality.

A total of 50,463 patients (22,722 before implementation of a frailty assessment initiative and 27,741 after implementation) with at least 1-year of postoperative follow-up were included in the analysis.

After implementation of the Epic Best Practice Alert-based frailty assessment initiative:

• the proportion of frail patients referred to a primary care physician and presurgical care clinic increased significantly from 9.8% to 24.6%
• multivariate regression analysis showed an 18% reduction in the odds of 1-year mortality
• interrupted time series models demonstrated a significant slope change in 365-day mortality from 0.12% preimplementation to -0.04% postimplementation
• among patients who triggered the Best Practice Alert, estimated 1-year mortality changed by -4.2%.

Future research should focus on implementing frailty screening in a broad range of practice settings and in identifying a set of interventions best suited to improving outcomes for frail patients before surgery, the authors say.