Fraility as a Predictor of Surgical Complications

MedicalResearch.com Interview with Kenneth Ogan MD
Department of Urology
Emory University School of Medicine
1365 Clifton Rd. NE, Building B, Suite 1400
Atlanta, Georgia 30322

MedicalResearch.com: What are the main findings of the study?

Dr. Ogan: Surgical risk assessment is traditionally a very subjective process, and an evaluation that more accurately measures a patient’s physiologic reserve would greatly aid in surgical decision making. In this study we sought to further characterize frailty as an objective risk assessment tool in surgical patients. We prospectively measured the five component frailty criteria described by Fried et al.1 (weight loss, exhaustion, low activity, grip strength, and gait speed).  Patients deemed “intermediately frail” and “frail” had twice the likelihood of experiencing any complication in the 30-day post-operative period.


MedicalResearch.com: Were any of the findings unexpected?

Dr. Ogan: We hypothesized that frailty would not be of use in minimally invasive surgery, however a subset analysis showed frailty conferred an even greater risk of post-operative complications in patients undergoing laparoscopic and robotic procedures.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Ogan: Measuring frailty in the pre-operative setting is both feasible and useful as it provides information beyond the traditional risk scores to identify surgical patients at increased risk for surgical complications.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ogan: We only included major intra-abdominal operations in our study, so future research should be focused on confirming these findings in more heterogeneous surgical populations. Additionally, a valuable study would be to determine the impact of preoperative interventions on postoperative outcomes in frail patients.

References

1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Geront A Biol Sci Med Sci. 2001; 56:146-156.

Citation:

Too Frail for Surgery?: Initial Results of a Large Multidisciplinary Prospective Study Examining Pre-operative Variables Predictive of Poor Surgical Outcomes

Louis M. Revenig, Daniel J. Canter, Maxwell D. Taylor, Caroline Tai, John F. Sweeney, Juan M. Sarmiento, David A. Kooby, Shishir K. Maithel, Viraj A. Master, Kenneth Ogan  

 

Journal of the American College of Surgeons – 27 June 2013 (10.1016/j.jamcollsurg.2013.06.012)  

 

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