Can adverse surgical outcomes be predicted by a validated frailty score in an elderly population undergoing elective general surgery?
To assess whether the use of a validated frailty score correlates with outcomes in elderly patients undergoing elective general surgery.
A 3 month prospective study was conducted; enrolling 79 patients aged ≥65 years having elective general surgical operations. These patients were stratified into two groups as per Rockwood Clinical Frailty score (RFS); 58 patients in low frailty group (LFG) with a RFS ≤3 and 21 patients in high frailty group (HFG) with a RFS>3. For data analysis, the statistical significance was set at a p-value of less than 0.05.
8 out of 21 patients in the HFG were recorded as having post-operative complications when compared to 12 out of 58 in the LFG; reaching statistical significance (p = 0.02). The 90 day mortality rate was higher in HFG (3 patients) when matched with LFG (0 patients) (p = 0.04). Similarly the duration of hospital stay was longer in patients of HFG as compared to the patients in LFG (p = 0.006 ). However, neither of the two groups showed any statistical difference with regards to rate of readmission to the hospital within 30 days of the primary surgery (p = 0.11).
Our study has demonstrated that a recognized frailty score can predict adverse surgical outcomes in an elderly population undergoing elective general surgery. Estimation of these outcomes may thus help to establish prospects about recovery after surgery and to facilitate optimal resource management.