Kaitlyn D’Onofrio

DocwireNews

Preoperative <a href="https://proddocwire.wpengine.com/orthopedic-surgery/frailty-and-malnutrition-are-associated-with-inpatient-postoperative-complications-and-mortality-in-hip-fracture-patients/">frailty</a> may be a significant risk factor in operative patients across subspecialties, according to a recent study.&ldquo;<a href="https://proddocwire.wpengine.com/abstracts/clinical-obstructive-pulmonary-disease/">Frailty</a> is an emerging risk factor for surgical outcomes, however its application across large populations is not well defined,&rdquo; the study authors wrote.To study its impact, researchers prospectively measured frailty in <a href="https://proddocwire.wpengine.com/abstracts/impact-of-frailty-on-short-term-outcomes-in-patients-undergoing-transsphenoidal-pituitary-surgery/">elective surgery patients</a> from a single health care system comprised of four hospitals between January 2016 and June 2017. Using the modified Hopkins score to measure frailty, patients were classified as low (0), intermediate (1-2), or high (3-5), and operations were classified as inpatient or outpatient. Thirty-day major morbidity, discharge location, emergency department visit, readmission, length of stay, mortality, and direct-cost/patient.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Frailty matters. <a href="https://t.co/GMP6O58FZr">https://t.co/GMP6O58FZr</a>
&mdash; Timothy A Mixon MD (@stemiusa) <a href="https://twitter.com/stemiusa/status/1102748804825128966?ref_src=twsrc%5Etfw">March 5, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script><h2>Frailty Affects Outcomes Across Surgeries</h2>A total of 14,530 elective <a href="https://proddocwire.wpengine.com/docwire-pick/overlapping-surgeries-safe/">surgery</a> patients (68.1% outpatient, 31.9% inpatient) were included; surgery classifications were: general, 29%; urology, 24%; plastic surgery, 13%; otolaryngology, 8%; podiatry, 6%; surgical oncology, 5%; cardiothoracic, 4%; colorectal, 4%; transplant, 3%; oral maxillofacial, 2%; and vascular, 2%. Overall, 3.4% of patients were classified as high frailty (5.3% inpatient, 2.5% outpatient. Across all patients, major morbidity, readmission, and mortality incidence rates were correlated with frailty classification (P &lt; 0.05). Among the inpatient group, higher frailty classification increased the risk for length of stay (low, 1.6 days; intermediate, 2.3 days; high 4.1 days; P &lt; 0.001) and discharge to facility (P &lt; 0.05). In the outpatient cohort, emergency department visit increased with frailty (P &lt; 0.05). Direct-cost also increased with frailty (low, $7,045; intermediate, $7,995; high, $8,599; P &lt; 0.05).<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
A large study evaluating frailty and outcomes in elective surgery from <a href="https://twitter.com/bswhealth?ref_src=twsrc%5Etfw">@bswhealth</a> 
Great work from <a href="https://twitter.com/claire_isbell?ref_src=twsrc%5Etfw">@claire_isbell</a> @erintbird and members of our Surgery Department! <a href="https://twitter.com/hashtag/populationhealthforsurgeons?src=hash&amp;ref_src=twsrc%5Etfw">#populationhealthforsurgeons</a>? <a href="https://t.co/Dg07sjhwey">https://t.co/Dg07sjhwey</a>
&mdash; Papaconstantinou, MD (@htpapaco) <a href="https://twitter.com/htpapaco/status/1102592450189803520?ref_src=twsrc%5Etfw">March 4, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>Frailty affected patients across age groups, the study authors noted.&ldquo;Frailty is identified as an important risk factor affecting surgical outcomes in <a href="https://proddocwire.wpengine.com/docwire-pick/cardiology-picks/frailty-common-older-patients/">elderly patients</a> and more recently also in younger patients, even people as young as 40,&rdquo; said lead study author Claire L. Isbell, MD, MSCI, FACS, a general surgeon at Baylor Scott &amp; White Memorial Hospital in Temple, Texas, <a href="https://www.eurekalert.org/pub_releases/2019-03/acos-fmb030119.php">in a press release</a>. &ldquo;With the national obesity epidemic, comorbidities typically seen later in life are increasingly prevalent in younger people.&rdquo;According to co-author Harry T. Papaconstantinou, MD, FACS, chairman of the department of surgery at Baylor Scott &amp; White Memorial Hospital, this study was the first to measure <a href="https://proddocwire.wpengine.com/gastroenterology/high-adherence-to-a-mediterranean-diet-and-lower-risk-of-frailty-among-french-older-adults-community-dwellers-results-from-the-three-city-bordeaux-study/">frailty&rsquo;s</a> effect in outcomes across subspecialties for inpatient and outpatient cohorts.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<a href="https://twitter.com/hashtag/prehabilitation?src=hash&amp;ref_src=twsrc%5Etfw">#prehabilitation</a> has all it importance while preparing major surgery: You would train for a marathon. Similarly, you have to get ready for an operation so you have the least possible risk of negative outcomes. <a href="https://t.co/la4VIOBz23">https://t.co/la4VIOBz23</a>
&mdash; Ihsan INAN, MD FMH FACS (@InanMD) <a href="https://twitter.com/InanMD/status/1102229895315423232?ref_src=twsrc%5Etfw">March 3, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>The study&rsquo;s findings demonstrate that patients should have conversations with their doctors prior to undergoing surgery, Papaconstantinou said.&ldquo;We think patients should discuss their frailty risk with their surgeon and the ways they can improve their health before their operation,&rdquo; he shared in a press release. &ldquo;You would train for a marathon. Similarly, you have to get ready for an operation so you have the least possible risk of negative outcomes.&rdquo;

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Preoperative frailty may be a significant risk factor in operative patients across subspecialties, according to a recent study. ...

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