ASSOCIATION BETWEEN FRAILTY AND CLINICAL OUTCOMES IN OLDER PATIENTS UNDERGOING SURGERY

Phạm Thị Thu Hiền1,, Nguyễn Toàn Thắng1,2
1 Hanoi Medical University
2 Bach Mai Hospital

Main Article Content

Abstract

Background: Older adults are a highly heterogeneous group with variable health and functional life courses. Beside, Older patients are undergoing surgery in increasing numbers and frailty is a key risk factor associated with higher rates of complications and mortality, longer hospital stays, and functional impairment. Objectives: To assess the frailty and the association between fraitly and Clinical outcomes in older patients undergoing surgery. Methods: cross-sectional study, 322 patients 60 years old or older were undergoing surgery in the Department general surgery,Hepato-biliary-Pancreatic Department,thoracic surgery Department at Bach Mai Hospital, we surveyed the weakened state according to Fried's criteria.We recorded the postoperative outcomes, defined complications and death, occurring within 30 days after surgery. Results: Of the 322 older patients undergoing elective surgery, 110 patients had fraitly, accounting for 34,16%. Within 30 days after surgery, 101 patients had complications and mortality, accounting for 31,4%. The rate of postoperative outcomes was significantly higher in frail group (57,8%) as compared to the non-frail group (17,2%), p <0.001. Conclusions: Frailty is a frequent syndrome in the perioperative setting and significantly increased complicative postoperation. So a routine frailty assessment is implemented.

Article Details

References

1. UNFPA Vietnam. Tọa đàm “Thích Ứng Với Già Hóa Dân Số Nhanh Ở Việt Nam: Con Đường Phía Trước” nhân ngày Quốc tế người cao tuổi 1/10/2018.
2. Hamel MB, Henderson WG, Khuri SF, Daley J. Surgical outcomes for patients aged 80 and older: morbidity and mortality from major noncardiac surgery. J Am Geriatr Soc. 2005;53(3):424-429.
3. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-M156.
4. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons - PubMed. Accessed July 21, 2021.
5. Nguyễn Vạn Thiện, Thân Hà Ngọc Thể. Ảnh hưởng của suy yếu lên kết cục lâm sàng 30 ngày ở người cao tuổi trải qua phẫu thuật tiêu hoá. Published online 2019.
6. Chen CC-H, Lin M-T, Liang J-T, Chen C-M, Yen C-J, Huang G-H. Pre-surgical Geriatric Syndromes, Frailty, and Risks for Postoperative Delirium in Older Patients Undergoing Gastrointestinal Surgery: Prevalence and Red Flags. J Gastrointest Surg. 2015;19(5):927-934.
7. Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a Predictor of Surgical Outcomes in Older Patients. J Am Coll Surg. 2010;210(6):901-908.
8. Hewitt J, Long S, Carter B, Bach S, McCarthy K, Clegg A. The prevalence of frailty and its association with clinical outcomes in general surgery: a systematic review and meta-analysis. Age Ageing. 2018;47(6):793-800.