Frailty Score Helps Predict Postoperative Mortality

MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of KoreaMedicalResearch.com Interview with:
Kwang-il Kim, MD, PhD
Associate Professor, Department of Internal Medicine,
Seoul National University College of Medicine,
Seoul National University Bundang Hospital,
Seoul, Republic of Korea

MedicalResearch: What are the main findings of the study?

Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly.

MedicalResearch: Were any of the findings unexpected?

Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point.

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

Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery.

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

Answer: This study has shown promising results in Korean surgical patients. So we want to know about inter-racial difference first. And further trials will aim to assess the effect of intervention to correct frailty of older surgical patients. Hopefully, the intervention would be effective in reversing the frailty and contributing to better post-operative outcomes.

Citation:

Sun-wook Kim, Ho-Seong Han, Hee-won Jung, Kwang-il Kim, Dae Wook Hwang, Sung-Bum Kang, Cheol-Ho Kim. Multidimensional Frailty Score for the Prediction of Postoperative Mortality Risk. JAMA Surgery, 2014; DOI: 10.1001/jamasurg.2014.241