The Edmonton Frail Scale as a preoperative assessment tool in elective outpatient surgery

Bautista, Lesley; DiDonato, Roberta; Bennett, Katie; Bautista, Michael

doi:10.1007/s12630-021-01954-y

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…La escala de fragilidad de Edmonton y sus posteriores modificaciones constituyen una herramienta válida y confiable para la identificación de la fragilidad en diferentes ámbitos incluido el anestésico-quirúrgico (12,(19)(20)(21)(22)(23) .…”

Section: Procedimientounclassified

Prevalencia de fragilidad en cirugía electiva para personas mayores usuarios del Hospital de Clínicas Análisis de la población quirúrgica de personas mayores del Hospital de Clínicas “Dr. Manuel Quintela” (marzo 2019-marzo 2020)

2023

RMU

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Section: Procedimientounclassified

Prevalencia de fragilidad en cirugía electiva para personas mayores usuarios del Hospital de Clínicas Análisis de la población quirúrgica de personas mayores del Hospital de Clínicas “Dr. Manuel Quintela” (marzo 2019-marzo 2020)

2023

RMU

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“…The Edmonton Frail Scale (EFS) is a multidomain assessment of frailty that is practical to implement in the preoperative setting. Like other frailty assessments, total EFS score has been associated with death, complications, and LOI 5–8 . However, compared with other frailty assessments, the EFS has the added advantage of assessing individual geriatric domains, including but not limited to cognition, functional performance, social support, weight loss, and mood.…”

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confidence: 99%

“…Like other frailty assessments, total EFS score has been associated with death, complications, and LOI. [5][6][7][8] However, compared with other frailty assessments, the EFS has the added advantage of assessing individual geriatric domains, including but not limited to cognition, functional performance, social support, weight loss, and mood. Although each of these domains may be optimized before surgery, it is unclear which domain is most strongly associated with LOI.…”

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confidence: 99%

Domains of Frailty Predict Loss of Independence in Older Adults After Noncardiac Surgery

Goeddel

Murphy

Owodunni³

et al. 2022

Annals of Surgery

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Importance: Preoperative frailty has been consistently associated with death, severe complications, and loss of independence (LOI) after surgery. LOI is an important patient-centered outcome, but it is unclear which domains of frailty are most strongly associated with LOI. Such information would be important to target individual geriatric domains for optimization. Objective: To assess whether impairment in individual domains of the Edmonton Frail Scale (EFS) can predict LOI in older adults after noncardiac surgery. Design: Retrospective Cohort Study. Setting: One Academic Hospital. Participants: Patients aged 65 or older who were living independently and evaluated with the EFS during a preoperative visit to the Center for Preoperative Optimization at the Johns Hopkins Hospital between June 2018 and January 2020. Main Outcome: LOI defined as discharge to increased level of care outside of the home with new mobility deficit or functional dependence. New mobility deficit and functional dependence were extracted from chart review of the standardized occupational therapy and physical therapy assessment performed before discharge. Results: A total of 3497 patients were analyzed. Age (mean±SD) was 73.4±6.2 years, and 1579 (45.2%) were female. The median total EFS score was 3 (range 0–16), and 725/3497 (27%) were considered frail (EFS≥6). The frequencies of impairment in each EFS domain were functional performance (33.5% moderately impaired, 11% severely impaired), history of hospital readmission (42%), poor self-described health status (37%), and abnormal cognition (17.1% moderately impaired, 13.8% severely impaired). Overall, 235/3497 (6.7%) patients experienced LOI. Total EFS score was associated with LOI (odds ratio: 1.37, 95% CI, 1.30–1.45, P<0.001) in a model adjusted for age, sex, body mass index, American Society of Anesthesiologists rating, congestive heart failure, valvular heart disease, hypertension diagnosis, chronic lung disease, diabetes, renal failure, liver disease, weight loss, anemia, and depression. Using a nested log likelihood approach, the domains of functional performance, functional dependence, social support, health status, and urinary incontinence improved the base multivariable model. In cross-validation, total EFS improved the prediction of LOI with the final model achieving an area under the curve of 0.840. Functional performance was the single domain that most improved outcome prediction, but together with functional dependence, social support, and urinary incontinence, the model resulted in an area under the curve of 0.838. Conclusion and Relevance: Among domains measured by the EFS before a wide range of noncardiac surgeries in older adults, functional performance, functional dependence, social support, and urinary incontinence were independently associated with and improved the prediction of LOI. Clinical initiatives to mitigate LOI may consider screening with the EFS and targeting abnormalities within these domains.

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Frailty in elderly undergoing cardiac surgery

Rewurai,

Saetang,

Sukkriang

2024

PSU Med J

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บทคัดย่อ (Abstracts) ปัจจุบันมีผู้สูงอายุที่มีภาวะเปราะบางที่ต้องเข้ารับการผ่าตัดหัวใจจำนวนมากขึ้น ซึ่งพบว่าภาวะแทรกซ้อน อัตราการเสียชีวิต ระยะเวลาการพักรักษาตัวและระยะเวลาการนอนโรงพยาบาลในหออภิบาลผู้ป่วยผ่าตัดหัวใจเพิ่มขึ้นมากกว่าผู้สูงอายุที่ไม่มีภาวะเปราะบาง ดังนั้นการประเมินความรุนแรงของภาวะเปราะบางก่อนผ่าตัดถือว่ามีความสำคัญมาก เพื่อวินิจฉัยภาวะเปราะบางได้อย่างรวดเร็ว และนำมาสู่การวางแผนดูแลรักษาผู้ป่วยที่ครอบคลุม ซึ่งสามารถลดความรุนแรงของภาวะแทรกซ้อน และอัตราการเสียชีวิตในระหว่างและหลังผ่าตัดหัวใจได้ บทความนี้จึงได้รวบรวมความรู้การประเมินความรุนแรงของภาวะเปราะบางก่อนผ่าตัด การดูแลผู้ป่วยที่มีภาวะเปราะบางทั้งระหว่างและหลังผ่าตัด เพื่อเป็นประโยชน์ในการดูแลผู้สูงอายุที่เข้ารับการผ่าตัดหัวใจ

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The Edmonton Frail Scale as a preoperative assessment tool in elective outpatient surgery

Cited by 3 publications

References 5 publications

Prevalencia de fragilidad en cirugía electiva para personas mayores usuarios del Hospital de Clínicas Análisis de la población quirúrgica de personas mayores del Hospital de Clínicas “Dr. Manuel Quintela” (marzo 2019-marzo 2020)

Prevalencia de fragilidad en cirugía electiva para personas mayores usuarios del Hospital de Clínicas Análisis de la población quirúrgica de personas mayores del Hospital de Clínicas “Dr. Manuel Quintela” (marzo 2019-marzo 2020)

Domains of Frailty Predict Loss of Independence in Older Adults After Noncardiac Surgery

Frailty in elderly undergoing cardiac surgery

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