Usefulness of the holistic context of frailty as a prognostic factor for the outcome of geriatric patients undergoing emergency abdominal surgery

被引:1
作者
Fuertes-Guiro, Fernando [1 ,2 ]
Vitali-Erion, Eduardo [3 ]
Rodriguez Fernandez, Amalia [3 ]
机构
[1] Univ Int Catalunya, Fac Med & Hlth Sci, Dept Surg, C Josep Trueta S-N, Barcelona 08195, Spain
[2] QSalud Univ Hosp, C Josep Trueta S-N, Barcelona 08195, Spain
[3] QSalud Univ Hosp, Dept Surg, Barcelona, Spain
来源
EUROPEAN SURGERY-ACTA CHIRURGICA AUSTRIACA | 2019年 / 51卷 / 05期
关键词
Frailty; Geriatric surgery; Prognostic factor; Morbimortality; Emergency surgery; SURGICAL OUTCOMES;
D O I
10.1007/s10353-019-0580-2
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background This study aims to assess frailty in a holistic context as a prognostic factor for the outcomes of a group of geriatric patients undergoing emergency abdominal surgery, identifying the predictors that could be included in a global assessment score of preoperative frailty. Methods Four groups of predictors (physical, cognitive, functional, and social) were evaluated in a group of patients selected for abdominal surgery during the preoperative period. The outcomes for three groups of variables (mortality, morbidity, and use of health resources) were measured using multivariate logistic regression when the response variable is categorical, and the multiple linear regression model for continuous numeric response variables. Results In the period studied, 286 patients aged 65 years or older required an emergency procedure. Physical/phenotypic predictors are consequently related to outcomes of morbidity and mortality and the use of resources, while predictors of mortality and socioeconomic factors predominate in functional and cognitive outcomes. Individually, Mini Nutritional Assessment (short form), sarcopenia, Pfeiffer, Barthel, and Duke tests best predict outcomes after emergency surgery. Conclusion Frailty is a predictive factor that should be routinely used in emergency geriatric surgery in a holistic context that includes physical, cognitive, functional, and social variables. Designing scores based on a broader concept of frailty will enable a more consistent predictive evaluation. Social frailty may have an important predictive value in the postoperative hospital outcome and in other medical fields, and should be studied in more depth in the future.
引用
收藏
页码:261 / 270
页数:10
相关论文
共 32 条
[1]   Factors influencing the length of hospital stay among patients resident in Blackpool admitted with COPD: a cross-sectional study [J].
Agboado, Gabriel ;
Peters, Jonathan ;
Donkin, Lynn .
BMJ OPEN, 2012, 2 (05)
[2]  
Agostini J.V., 2003, PRINCIPLES GERIATRIC, V5th, P1503
[3]  
[Anonymous], EUR J CARDIOVASC NUR
[4]   Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients [J].
Bo, Mario ;
Fonte, Gianfranco ;
Pivaro, Federica ;
Bonetto, Martina ;
Comi, Chiara ;
Giorgis, Veronica ;
Marchese, Lorenzo ;
Isaia, Gianluca ;
Maggiani, Guido ;
Furno, Elisabetta ;
Falcone, Yolanda ;
Isaia, Giovanni Carlo .
GERIATRICS & GERONTOLOGY INTERNATIONAL, 2016, 16 (03) :314-321
[5]   THE DUKE-UNC FUNCTIONAL SOCIAL SUPPORT QUESTIONNAIRE - MEASUREMENT OF SOCIAL SUPPORT IN FAMILY MEDICINE PATIENTS [J].
BROADHEAD, WE ;
GEHLBACH, SH ;
DEGRUY, FV ;
KAPLAN, BH .
MEDICAL CARE, 1988, 26 (07) :709-723
[6]   Frailty syndrome: an overview [J].
Chen, Xujiao ;
Mao, Genxiang ;
Leng, Sean X. .
CLINICAL INTERVENTIONS IN AGING, 2014, 9 :433-441
[7]   Frailty in elderly people [J].
Clegg, Andrew ;
Young, John ;
Iliffe, Steve ;
Rikkert, Marcel Olde ;
Rockwood, Kenneth .
LANCET, 2013, 381 (9868) :752-762
[8]   Tools in the Assessment of Sarcopenia [J].
Cooper, C. ;
Fielding, R. ;
Visser, M. ;
van Loon, L. J. ;
Rolland, Y. ;
Orwoll, E. ;
Reid, K. ;
Boonen, S. ;
Dere, W. ;
Epstein, S. ;
Mitlak, B. ;
Tsouderos, Y. ;
Sayer, A. A. ;
Rizzoli, R. ;
Reginster, J. Y. ;
Kanis, J. A. .
CALCIFIED TISSUE INTERNATIONAL, 2013, 93 (03) :201-210
[9]  
Fried Linda P, 2005, Sci Aging Knowledge Environ, V2005, ppe24, DOI 10.1126/sageke.2005.31.pe24
[10]   Emergency general surgery specific frailty index: A validation study [J].
Jokar, Tahereh Orouji ;
Ibraheem, Kareem ;
Rhee, Peter ;
Kulavatunyou, Narong ;
Haider, Ansab ;
Phelan, Herb A. ;
Fain, Mindy ;
Mohler, Martha Jane ;
Joseph, Bellal .
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2016, 81 (02) :254-260