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Association of Patient Frailty With Increased Morbidity After Common Ambulatory General Surgery Operations JAMA SURGERY Seib, C. D., Rochefort, H., Chomsky-Higgins, K., Gosnell, J. E., Suh, I., Shen, W. T., Duh, Q., Finlayson, E. 2018; 153 (2): 160–68

Abstract

Frailty is a measure of decreased physiological reserve that is associated with morbidity and mortality in major elective and emergency general surgery operations, independent of chronological age. To date, the association of frailty with outcomes in ambulatory general surgery has not been established.To determine the association between frailty and perioperative morbidity in patients undergoing ambulatory general surgery operations.A retrospective cohort study was conducted of 140?828 patients older than 40 years of age from the 2007-2010 American College of Surgeons National Surgical Quality Improvement Program Participant Use File who underwent ambulatory and 23-hour-stay hernia, breast, thyroid, or parathyroid surgery. Data analysis was performed from August 18, 2016, to June 21, 2017.The association between the National Surgical Quality Improvement Program modified frailty index and perioperative morbidity was determined via multivariable logistic regression with random-effects modeling to control for clustering within Current Procedural Terminology codes.A total of 140?828 patients (80?147 women and 60?681 men; mean [SD] age, 59.3 [12.0] years) underwent ambulatory hernia (n?=?71?455), breast (n?=?51?267), thyroid, or parathyroid surgery (n?=?18?106). Of these patients, 2457 (1.7%) experienced any type of perioperative complication and 971 (0.7%) experienced serious perioperative complications. An increasing modified frailty index was associated with a stepwise increase in the incidence of complications. In multivariable analysis adjusting for age, sex, race/ethnicity, anesthesia type, tobacco use, renal failure, corticosteroid use, and clustering by Current Procedural Terminology codes, an intermediate modified frailty index score (0.18-0.35, corresponding to 2-3 frailty traits) was associated with statistically significant odds ratios of 1.70 (95% CI, 1.54-1.88; P?

View details for DOI 10.1001/jamasurg.2017.4007

View details for Web of Science ID 000425676000017

View details for PubMedID 29049457

View details for PubMedCentralID PMC5838594