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dc.contributor.authorLin, H
dc.contributor.authorPeel, NM
dc.contributor.authorScott, IA
dc.contributor.authorVardesh, DL
dc.contributor.authorSivalingam, P
dc.contributor.authorMcBride, RL
dc.contributor.authorMorong, JJ
dc.contributor.authorNelson, MJ
dc.contributor.authorHubbard, RE
dc.date.accessioned2020-03-05T02:05:07Z
dc.date.available2020-03-05T02:05:07Z
dc.date.issued2017
dc.identifier.issn0310-057X
dc.identifier.doi10.1177/0310057X1704500605
dc.identifier.urihttp://hdl.handle.net/10072/392117
dc.description.abstractThis study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≥0.25, >0.25 to 0.4, and >0.4, respectively. Adverse outcomes were ascertained at 30 days and 12 months post-surgery. Logistic regression models assessed the relationship between FI and adverse outcomes, adjusting for age, gender and acuity of surgery. The mean age of the participants was 79 years (standard deviation [SD] 6.5%), 52% were female, 91% were admitted from the community, 43% underwent acute surgery, and 19% were assessed as frail. The FI-CGA form was reported as being easy to apply, with a low patient refusal rate (2.2%). The majority of items were easy to rate, although inter-rater reliability was not tested. In relation to outcomes, greater frailty was associated with increased 12-month mortality (6.4%, 15.6%, and 23% for fit, intermediate frail, and frail patients respectively, P=0.01) and 12-month hospital readmission (33.9%, 48.9%, and 60% respectively, P=0.004). There were no statistically significant differences between fit, intermediate frail, and frail groups in perioperative adverse events (17.4%, 23.3%, and 19.1% respectively, P=0.577) or 30-day postoperative complications (35.8%, 47.8%, and 46.8% respectively, P=0.183). Our findings suggest that it is feasible to use the FI-CGA to assess frailty preoperatively, and that using the FI-CGA may identify patients at high risk of adverse long-term outcomes.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherSage
dc.relation.ispartofpagefrom676
dc.relation.ispartofpageto682
dc.relation.ispartofissue6
dc.relation.ispartofjournalAnaesthesia and Intensive Care
dc.relation.ispartofvolume45
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchcode32
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsAnesthesiology
dc.subject.keywordsCritical Care Medicine
dc.subject.keywordsGeneral & Internal Medicine
dc.titlePerioperative assessment of older surgical patients using a frailty index-feasibility and association with adverse postoperative outcomes
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationLin, H; Peel, NM; Scott, IA; Vardesh, DL; Sivalingam, P; McBride, RL; Morong, JJ; Nelson, MJ; Hubbard, RE, Perioperative assessment of older surgical patients using a frailty index-feasibility and association with adverse postoperative outcomes, Anaesthesia and Intensive Care, 2017, 45 (6), pp. 676-682
dc.date.updated2020-03-05T01:48:28Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2017 Australian Society of Anaesthetists. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
gro.hasfulltextFull Text
gro.griffith.authorVardesh, Deepak L.


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