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Preoperative Frailty Linked to Surgical Outcomes, Costs

Incidence of major morbidity, readmission, mortality correlated with frailty classification

WEDNESDAY, March 6, 2019 (HealthDay News) — Preoperative frailty is associated with surgical outcomes and costs in patients undergoing elective surgery, according to a study published online March 1 in the Journal of the American College of Surgeons.

Mary M. Mrdutt, M.D., from the Baylor Scott & White Memorial Hospital in Temple, Texas, and colleagues prospectively measured frailty in elective surgery patients in a health care system. Frailty was classified according to the modified Hopkins score. Data were included for 14,530 patients (68.1 percent outpatient; 31.9 percent inpatient).

The researchers found that 3.4 percent of patients had high frailty (5.3 percent inpatient; 2.5 percent outpatient). For all patients, the incidence of major morbidity, readmission, and mortality correlated with frailty classification (P < 0.05). In the inpatient cohort, increasing frailty was associated with increasing length of stay in days (low, 1.6 days; intermediate, 2.3 days; high, 4.1 days; P < 0.0001) and discharge to facility (P < 0.05). Frailty was associated with an increase in emergency department visits (P < 0.05) in the outpatient cohort and was correlated with increased direct cost in the inpatient cohort (low, $7,045; intermediate, $7,995; and high, $8,599; P < 0.05).

“Mitigation of risk factors in frail patients could offer significant improvements in quality outcomes in a large patient population and provide cost savings,” the authors write.

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