The association between frailty and ageing: Results from an observational study including 9497 elderly patients

Abstract

BackgroundElderly surgical patients have a high risk of postoperative complications. However, patients exhibit considerable diversity in health and functional status; thus, identifying the fragile may be necessary when selecting surgical candidates. We aimed to compare the prevalence of frailty in patients ≥90 years with patients aged 80–89. Second, we assessed the association between frailty and all‐cause 30‐day mortality.MethodsWe performed a planned secondary analysis of the peri‐interventional outcome study in the elderly (POSE), including 9497 patients (≥80 years) undergoing any surgical and nonsurgical procedures in 177 European centres from October 2017 to December 2018. The primary outcome assessment included frailty as a binary variable, and data were analysed using Fisher's exact test/Chi‐squared test. The association between frailty and all‐cause 30‐day mortality was analysed using a multivariate logistic regression model adjusted for age, sex, surgical urgency, orthopaedic urgency, and surgical severity.ResultsIn total, 999 of 9497 (10.5%) patients were 90 years or above. Among patients ≥90 years, 274 (27.4%) were frail compared to 1062 (12.5%) of patients aged 80–89 (odds ratio (OR): 2.6; 95% CI 2.3–3.1). Frailty was associated with increased 30‐day mortality in both the unadjusted (crude OR 6.3; 5.1–7.7) and adjusted analysis (OR 4.5; 3.6–5.7). In the adjusted analysis, age ≥90 was not associated with 30‐day mortality.ConclusionWe found a high frequency of frailty in patients aged 90 years or above compared with patients aged 80–89. In addition, frailty was associated with an increased risk of 30‐day mortality. Surprisingly, age was not a significant risk factor in the adjusted mortality analysis.