Screening older surgery patients for frailty could improve their outcomes and chances for survival, researchers say.
But frailty often goes unrecognized in these patients, according to a study published online Oct. 6 in The Annals of Thoracic Surgery.
“Patients with frail health have less ability to overcome stressors such as illness, falls and injury, and have a higher risk of adverse effects from medications, procedures and surgery,” study co-author Dr. Angela Beckert said in a journal news release. Beckert is an assistant professor in the division of geriatrics and gerontology at the Medical College of Wisconsin, in Milwaukee.
“If a patient is more robust, with better physical performance and vigor — in other words, less frail — then I believe surgical outcomes would be better,” she added.
Beckert’s team screened 125 patients for signs of frailty; their average age was 70. The patients were being assessed for major thoracic surgery such as full or partial removal of the esophagus, lung or chest resection.
The frailty screening checked for five traits: unintentional weight loss, weakness (grip strength), exhaustion, low activity level and slow gait. Exhaustion was most often found; slow gait, the least often, according to the study authors.
Nearly 69 percent of the patients in the study were found to be frail or “pre-frail” — suggesting the problem may be seriously under-recognized.
“This study indicated that a large number of patients who are candidates for major surgery have important risk factors related to frailty,” study co-author Dr. Mark Ferguson, a thoracic surgeon, said in the news release.
“Knowing what these factors are can help physicians, patients and the patients’ families better understand the risks and may motivate them to participate in activities that reduce their risks,” he said. Ferguson is a professor of surgery at University of Chicago School of Medicine.
Frailty increases the odds for surgical complications and higher health costs. Frail patients are likely to spend more time in the hospital and to be discharged to a rehabilitation facility instead of home. They also are more likely to be readmitted to the hospital and to have a poorer quality of life, according to the study.
The U.S. National Institute on Aging has more about surgery.
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