Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Frailty in older patients undergoing emergency laparotomy

Parmar, Kat L., Law, Jennifer, Carter, Ben, Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792, Boyle, Jemma M., Casey, Patrick, Maitra, Ishaan, Farrell, Ian S., Pearce, Lyndsay and Moug, Susan J. 2021. Frailty in older patients undergoing emergency laparotomy. Annals of Surgery 273 , pp. 709-718. 10.1097/SLA.0000000000003402

[thumbnail of ELF vX main paper Watermark_.pdf]
Preview
PDF - Accepted Post-Print Version
Download (491kB) | Preview

Abstract

Objective: This study aimed to document the prevalence of frailty in older adults undergoing emergency laparotomy and to explore relationships between frailty and postoperative morbidity and mortality. Summary Background Data: The majority of adults undergoing emergency laparotomy are older adults (≥65 y) that carry the highest mortality. Improved understanding is urgently needed to allow development of targeted interventions. Methods: An observational multicenter (n=49) UK study was performed (March–June 2017). All older adults undergoing emergency laparotomy were included. Preoperative frailty score was calculated using the progressive Clinical Frailty Score (CFS): 1 (very fit) to 7 (severely frail). Primary outcome measures were the prevalence of frailty (CFS 5–7) and its association to mortality at 90 days postoperative. Secondary outcomes included 30-day mortality and morbidity, length of critical care, and overall hospital stay. Results: A total of 937 older adults underwent emergency laparotomy: frailty was present in 20%. Ninety-day mortality was 19.5%. After age and sex adjustment, the risk of 90-day mortality was directly associated with frailty: CFS 5 adjusted odds ratio (aOR) 3.18 [95% confidence interval (CI), 1.24–8.14] and CFS 6/7 aOR 6·10 (95% CI, 2.26–16.45) compared with CFS 1. Similar associations were found for 30-day mortality. Increasing frailty was also associated with increased risk of complications, length of Intensive Care Unit, and overall hospital stay. Conclusions: A fifth of older adults undergoing emergency laparotomy are frail. The presence of frailty is associated with greater risks of postoperative mortality and morbidity and is independent of age. Frailty scoring should be integrated into acute surgical assessment practice to aid decision-making and development of novel postoperative strategies.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Lippincott, Williams & Wilkins
ISSN: 0003-4932
Date of First Compliant Deposit: 23 July 2019
Date of Acceptance: 1 June 2019
Last Modified: 07 Nov 2023 00:51
URI: https://orca.cardiff.ac.uk/id/eprint/124440

Citation Data

Cited 112 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics