Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized
The American Journal of Surgery, 07/27/2012
Tan KY et al. – Preliminary findings show that frailty is a potent adjunctive tool of predicting postoperative morbidity. Frailty can be used to identify elderly patients needing further optimization before major surgery.Methods
- A prospective study was conducted at 2 centers (Singapore and Japan).
- All patients over 75 years of age undergoing colorectal resection were assessed for the presence of the syndrome of frailty.
- All these patients had already had their comorbidities optimized for surgery.
- The outcome measure was postoperative major complications (defined as Clavien–Dindo type II and above complications).
- Eighty–three patients were studied from February 2008 to April 2010.
- The mean age was 81.5 years (range 75–93 years).
- The mean comorbidity index was 3.37 (range 0–11).
- Twenty–six (31.3%) patients were an American Society of Anesthesiologists (ASA) score of 3 and above.
- Chi–square analysis revealed that the odds ratio of postoperative major complications was 4.083 (95% confidence interval, 1.433–11.638) when the patient satisfied the criteria for frailty.
- Albumin <35, ASA >3, comorbidity index >5, and Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scores were not predictive of postoperative major complications.