Frailty predicts outcome of elective laparoscopic cholecystectomy in geriatric patients

Lasithiotakis, Konstantinos; Petrakis, John; Venianaki, Maria; Georgiades, George; Koutsomanolis, Dimosthenis; Andreou, Alexander; Zoras, Odysseas; Chalkiadakis, George

doi:10.1007/s00464-012-2565-0

Cited by 49 publications

(45 citation statements)

References 24 publications

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“…Four studies involved patients having cardiac valve surgery (including transcatheter aortic valve repplacement). 4,[22][23][24] Five studies involved a mix of gastrointestinal surgical patients, [25][26][27] including abdominal 21 and other general surgery patients. 28 Two studies involved vascular surgical patients 29,30 and two involved surgical oncology patients with either gynecological neoplasms 31 or gastric adenocarcinoma.…”

Section: Basic Study Characteristicsmentioning

confidence: 99%

“…25 Eight studies showed an association between frailty and the development of postoperative complications. 20,21,26,27,31,34,36,37 As with mortality, a wide variety of ORs was reported for the development of complications, likely also due to the variation in surgical population and frailty assessment used. With respect to 30-day postoperative complications, the OR ranged from as low as 1.05 (95% CI 0.94 to 1.17) in older adult abdominal surgical patients 21 to as high as 11.70 in patients undergoing emergency general surgery.…”

Section: Frailty and Perioperative Surgical Outcomesmentioning

confidence: 99%

“…30 Various studies consistently listed infectious causes as the leading cause of postoperative complications. 21,[26][27][28]30 Infection often manifested itself as surgical site infection but also included pneumonia, urinary tract infection (UTI), and septicemia. In addition, those deemed more frail using a modified frailty index (mFI) showed an increased incidence of prolonged ventilation (38.9%) and re-intubation (22.2%).…”

Section: Frailty and Perioperative Surgical Outcomesmentioning

confidence: 99%

“…In addition, those deemed more frail using a modified frailty index (mFI) showed an increased incidence of prolonged ventilation (38.9%) and re-intubation (22.2%). 26 Delirium was another common…”

Section: Frailty and Perioperative Surgical Outcomesmentioning

confidence: 99%

“…There was a significant correlation between myocardial infarctions and increased frailty scores. 26 Another common cardiac complication was arrhythmia, 27,28,37 which was present in up to 3.6% of patients in some studies. 28 These are important complications that anesthesiologists and intensivists may have to manage in the postoperative period.…”

Section: Clinical Frailty Scale (Cfs)mentioning

confidence: 99%

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Frailty and perioperative outcomes: a narrative review

Beggs

Sepehri

Szwajcer

et al. 2014

Can J Anesth/J Can Anesth

147

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Background Frailty has no single universally accepted definition or method for assessment. It is commonly defined from a physiological perspective as a disruption of homeostatic mechanisms ultimately leading to a vulnerable state. Numerous scoring indices and assessments exist to assist clinicians in determining the frailty status of a patient. The purpose of this review is to discuss the relationship between frailty and perioperative outcomes in surgical patients. Principal findings We performed a review to determine the association of frailty with perioperative outcomes in patients undergoing a wide variety of surgical procedures. A scoping literature search was performed to capture studies from MEDLINE Ò , EMBASE TM , and CENTRAL (Cochrane), which resulted in locating 175 studies across the three electronic databases. After an article screening process, 19 studies were found that examined frailty and perioperative outcomes. The studies used a range of assessments to determine frailty status and included patients in a variety of surgical fields. Regardless of surgical population and method of frailty assessment, a relationship existed between adverse perioperative outcomes and frailty status. Frail patients undergoing surgical procedures had a higher likelihood than non-frail patients of experiencing mortality, morbidity, complications, increased hospital length of stay, and discharge to an institution. Conclusions Patients undergoing surgery who are deemed frail, regardless of the scoring assessment used, have a higher likelihood of experiencing adverse perioperative outcomes. With the lack of a unified definition for frailty, further research is needed to address which assessment method is most predictive of adverse postoperative outcomes.

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