Transition in Frailty State Among Elderly Patients After Vascular Surgery

Visser, Linda; Zeebregts, Clark J.; Leeuwen, Barbara L. van; Moumni, Mostafa El; Pol, Robert A.

doi:10.1007/s00268-020-05619-7

Cited by 12 publications

(7 citation statements)

References 55 publications

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“…And finally, 7 out of 8 studies used retrospectively collected data to determine the frailty status. Since frailty is a dynamic condition that fluctuates in time, it is difficult, if not impossible, to reliably interpret retrospectively collected results (38,39).…”

Section: Discussionmentioning

confidence: 99%

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Benjamens¹,

Bokkers²,

Zeebregts³

et al. 2021

Ann Transl Med

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Carotid endarterectomy (CEA) is a surgical treatment option to prevent ischemic cerebrovascular accidents. Patients that present with pre-operative frailty might have an elevated risk for unfavorable outcomes after the CEA. A systematic search, using Medline, Embase, Web of Science and Cochrane Database, was performed for relevant literature on frailty in patients undergoing CEA. The study protocol was registered with PROSPERO (CRD42020190345). Eight articles were included. The pooled prevalence for pre-operative frailty was 23.9% (95% CI: 12.98-34.82). A difference in the incidence of complications between frail and non-frail patients (6.4% vs. 5.2%, respectively) and a difference in hospital length of stay [2 (IQR: 2-3) days vs. 1 (IQR: 1-2) day, respectively] were described. The 30-day mortality after CEA was 0.6% for non-frail patients, 2.6% for frail patients, and 4.9% for very frail patients (P<0.001). For 3-year mortality, a >1.5-fold increased risk was found for frail patients (OR 1.7, 95% CI: 1.4-2.0) and a >2.5-fold increased risk for very frail patients (OR 2.6, 95% CI: 2.2-3.1). In conclusion, this review shows the impact of frailty on outcome after CEA. Pre-operative frailty assessment with a validated, multi-domain tool should be implemented in the clinical setting as it will provide information on post-operative surgical outcomes and mortality risk but also frailty trajectory and cognitive decline.

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Section: Discussionmentioning

confidence: 99%

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Benjamens¹,

Bokkers²,

Zeebregts³

et al. 2021

Ann Transl Med

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“…Previous studies have measured frailty in patients undergoing vascular surgery. 35 And studies have shown that the debilitating evaluation of patients with surgery and cancer is beneficial to explore the quality of life, survival rate and recovery effect of patients. 52 Our results show that frailty is negatively correlated with compliance, this indicates that the health status of the patients after surgery needs our attention.…”

Section: Discussionmentioning

confidence: 99%

Frailty, Illness Perception and Lung Functional Exercise Adherence in Lung Cancer Patients After Thoracoscopic Surgery

Gu,

Shen,

Chu

et al. 2023

PPA

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Background Lung cancer patients will have lung damage after surgery, need rehabilitation exercise. Common-sense model has shown the impact of patients’ perception of illness on health behaviors. However, for patients with lung cancer after thoracoscopic surgery, there has been no relevant exploration of disease perception. Objective The purpose of this study was to investigate the clinical status of patients with lung cancer patients who have undergone thoracoscopic surgery, and to explore the correlation between frailty, disease perception, and lung functional exercise compliance. Methods The cross-sectional study included 218 patients with lung cancer after thoracoscopic surgery. We collected participants’ frailty, disease perception, exercise adherence, and relevant clinical information. T -test, Chi-square, Linear regression, Pearson’s correlation, and mediation analysis were used for statistical analysis of patient data. Results We analyzed the data by disease perception with high and low median scores and found significant differences in lymphatic dissection, stool within three days, pain, thoracic drainage tube placement time. Linear regression results show that, after controlling for confounding factors, frailty and disease perception were significantly associated with pulmonary function exercise compliance. The higher the frailty score, the worse the compliance, and the higher the disease perception negative score, the less exercise. Illness perception played a partially mediating role in the association between frailty and lung functional exercise adherence. Conclusion Frailty and disease perception have an impact on exercise adherence, therefore, we need to consider these factors in the intervention to improve exercise compliance after thoracoscopic surgery for lung cancer.

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“…Coupled with chronic inflammation from limb ischaemia, tissue loss and chronic infection (often present in CLTI), it is unsurprising that a higher proportion of those with more severe CLTI are living with frailty [ 8 ]. There is some evidence that, in a small proportion of patients, frailty trajectory may be slowed or reversed after successful revascularisation in those with CLTI and frailty [ 31 ].…”

Section: Pad In Older Peoplementioning

confidence: 99%

New Horizons in Peripheral Artery Disease

Houghton,

Saratzis,

Sayers

et al. 2024

Age and Ageing

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Peripheral artery disease (PAD) is the lower limb manifestation of systemic atherosclerotic disease. PAD may initially present with symptoms of intermittent claudication, whilst chronic limb-threatening ischaemia (CLTI), the end stage of PAD, presents with rest pain and/or tissue loss. PAD is an age-related condition present in over 10% of those aged ≥65 in high-income countries. Guidelines regarding definition, diagnosis and staging of PAD and CLTI have been updated to reflect the changing patterns and presentations of disease given the increasing prevalence of diabetes. Recent research has changed guidelines on optimal medical therapy, with low-dose anticoagulant plus aspirin recommended in some patients. Recently published randomised trials highlight where bypass-first or endovascular-first approaches may be optimal in infra-inguinal disease. New techniques in endovascular surgery have increased minimally invasive options for ever more complex disease. Increasing recognition has been given to the complexity of patients with CLTI where a high prevalence of both frailty and cognitive impairment are present and a significant burden of multi-morbidity and polypharmacy. Despite advances in minimally invasive revascularisation techniques and reduction in amputation incidence, survival remains poor for many with CLTI. Shared decision-making is essential, and conservative management is often appropriate for older patients. There is emerging evidence of the benefit of specialist geriatric team input in the perioperative management of older patients undergoing surgery for CLTI. Recent UK guidelines now recommend screening for frailty, cognitive impairment and delirium in older vascular surgery patients as well as recommending all vascular surgery services have support and input from specialist geriatrics teams.

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Transition in Frailty State Among Elderly Patients After Vascular Surgery

Cited by 12 publications

References 55 publications

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Role of pre-operative frailty status in relation to outcome after carotid endarterectomy: a systematic review

Frailty, Illness Perception and Lung Functional Exercise Adherence in Lung Cancer Patients After Thoracoscopic Surgery

New Horizons in Peripheral Artery Disease

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