Preop frailty linked to surgical outcomes

Editor's Note

In this study of adult surgical patients across all ages, frailty was associated with higher postoperative rates of major illness and readmissions as well as increased costs.

Of 14,530 patients (31.9% inpatient, 68.1% outpatient) analyzed, 3.4% had high frailty (5.3% of inpatients and 2.5% of outpatients).

Compared with low frailty, the presence of high frailty was linked to significantly worse 30-day outcomes, including:

• Increased risk of a major complication (1.8 and 2.9 greater odds in inpatients and outpatients, respectively).
• Longer median hospital stay of 2.5 days, higher costs, and a 5.6 times greater chance of being discharged to a nursing facility for inpatients.
• Greater chance of readmission (2.3 times the odds for inpatients and 4.8 times for outpatients).
• More than two times the odds of an emergency department visit after an outpatient procedure.

Intermediate frailty also significantly increased the risk of all adverse outcomes.

The broad applicability of frailty across surgical specialties has the potential to be a risk stratification tool for surgeons and their patients, the researchers conclude.