McGuckin, DG;
Mufti, S;
Turner, DJ;
Bond, C;
Moonesinghe, SR;
(2018)
The association of peri-operative scores, including frailty, with outcomes after unscheduled surgery.
Anaesthesia
, 73
(7)
pp. 819-824.
10.1111/anae.14269.
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Abstract
Summary Postoperative hospital stay is longer for frail, older patients, who are more likely to experience prolonged postoperative morbidity and reduced long‐term survival. We recorded in‐hospital mortality, morbidity and length of stay for 164 patients aged at least 65 years after unscheduled surgery. We evaluated pre‐operative frailty with the 7‐point Clinical Frailty Scale: 81 patients were ‘not vulnerable’ (frailty score 1–3) and 83 were ‘vulnerable or frail’ (frailty score urn:x-wiley:00032409:media:anae14269:anae14269-math-0001 4), with mean (SD) ages of 74.7 (7.5) years vs. 79.4 (8.3) years, respectively, p < 0.001. Within 30 postoperative days 8/164 (5%) patients died, all with frailty scores urn:x-wiley:00032409:media:anae14269:anae14269-math-0002 4, p = 0.007. Postoperative morbidity was less frequent in patients categorised as ‘not vulnerable’ on four out of the six days it was measured (days 3, 5, 8, 14, 23, 28). Median (IQR [range]) postoperative stay was 9 (6–18 [2–221]) days for patients with frailty scores 1–3, and 22 (12–33 [2–270]) days for patients with score urn:x-wiley:00032409:media:anae14269:anae14269-math-0003 4, p < 0.001. Four variables independently associated with hospital discharge, hazard ratio (95%CI): E‐POSSUM, 0.74 (0.60–0.92), p = 0.007; ASA 2, 0.35 (0.13–0.98), p = 0.046, ASA 3, 0.17 (0.06–0.47), p = 0.001 and ASA 4/5, 0.08 (0.02–0.28), p < 0.001; operative severity ‘major +’, 0.69 (0.41–1.08), p = 0.10 and the Surgical Outcome Risk Tool, 7.75 (0.81–74.40), p = 0.08.
| Type: | Article |
|---|---|
| Title: | The association of peri-operative scores, including frailty, with outcomes after unscheduled surgery |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/anae.14269 |
| Publisher version: | https://doi.org/10.1111/anae.14269 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Anesthesiology, ageing, ASA physical status, geriatric anaesthesia, quality measures: patient care, POSTOPERATIVE MORBIDITY SURVEY, SURGICAL OUTCOMES, ELDERLY-PEOPLE, MAJOR SURGERY, MORTALITY, OLDER, RISK, PREDICTION, VALIDATION, PATIENT |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10056242 |
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