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Frailty assessment tools and associated postoperative outcomes in older patients undergoing elective surgery: A prospective pilot study
被引:3
作者:
Rabelo, Luis G.
[1
,2
]
Bjornsdottir, Anna
[3
]
Jonsdottir, Anna B.
[4
]
Einarsson, Sveinn G.
[1
]
Karason, Sigurbergur
[1
]
Sigurdsson, Martin, I
[1
,2
]
机构:
[1] Landspitali Natl Univ Hosp Iceland, Perioperat Serv, Div Anaesthesia & Intens Care Med, Hringbraut 101, IS-101 Reykjavik, Iceland
[2] Univ Iceland, Fac Med, Reykjavik, Iceland
[3] Heilsuklasinn Neurol Clin, Reykjavik, Iceland
[4] Landspitali Natl Univ Hosp Iceland, Geriatr & Rehabil Serv, Reykjavik, Iceland
关键词:
clock drawing test (CDT);
frailty risk;
postoperative outcomes;
preoperative assessment;
PRISMA7;
Timed Up and Go (TUG);
CLOCK-DRAWING TEST;
SCREENING TOOL;
FEASIBILITY;
ADULTS;
GO;
PREHABILITATION;
INSTRUMENTS;
ACCURACY;
PROPOSAL;
HEALTH;
D O I:
10.1111/aas.14162
中图分类号:
R614 [麻醉学];
学科分类号:
100217 ;
摘要:
Background There is a need for a feasible tool to assess the risk of frailty prior to surgery. We aimed to identify the ratio of abnormal results for three clinically applicable screening tools to assess the risk of frailty, and their association with adverse outcomes in a cohort of elderly surgical patients. Methods In this prospective pilot study, patients >= 65 years undergoing preoperative evaluation for elective surgery were included and subjected to three frailty screening tests; Program of Research to Integrate Services for the Maintenance of Autonomy 7-item questionnaire (PRISMA7), Timed Up and Go (TUG), and Clock Drawing Test (CDT). The primary outcome was the incidence of abnormal testing, and secondary outcomes were the association between abnormal tests and mortality, readmission, delirium, surgical complications and non-home discharge. Results Out of 99 patients, 41%, 37%, and 43% had abnormal PRISMA7, TUG, and CDT screening, respectively. Postoperative delirium was more likely to occur in patients with abnormal TUG screening (19% vs. 3%, p = .011) and CDT (17% vs. 2%, p = .019). When analyzing screening tool combinations, patients with abnormal PRISMA7 and TUG had a higher rate of non-home discharge (38% vs. 17%, p = .029); and patients with abnormal TUG and CDT had a higher rate of postoperative delirium (25% vs. 3%, p = .006) and any surgical complication (58% vs. 38%, p = .037); and patients with abnormal results from all three tools had a higher rate of postoperative delirium (21% vs. 5%, p = .045) and non-home discharge (42% vs. 18%, p = .034). Conclusion Approximately 40% of elderly surgical patients have abnormal PRISMA7, TUG, and CDT screening tests for frailty, and they are associated individually or in combination with increased risk of adverse postoperative outcomes. The results will aid in designing studies to further risk-stratify patients at risk of frailty and attempt to modify associated outcomes.
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页码:150 / 158
页数:9
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