Frailty as a predictor of mortality in the elderly emergency general surgery patient

Goeteyn, Jens, Evans, Louis, De Cleyn, Siem, Fauconnier, Sigrid, Damen, Caroline, Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792 and Ceelen, Wim 2017. Frailty as a predictor of mortality in the elderly emergency general surgery patient. Acta Chirurgica Belgica 117 (6) , pp. 370-375. 10.1080/00015458.2017.1337339 Item availability restricted.

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Abstract

Background: The number of surgical procedures performed in elderly and frail patients has greatly increased in the last decades. However, there is little research in the elderly emergency general surgery patient. The aim of this study was to assess the prevalence of frailty in the emergency general surgery population in Belgium. Secondly, we examined the length of hospital stay, readmission rate and mortality at 30 and 90 days. Methods: We conducted a prospective observational study at Ghent University Hospital. All patients older than 65 admitted to a general surgery ward from the emergency department were eligible for inclusion. Primary endpoint was mortality at 30 days. Secondary outcomes were mortality at 90 days, readmissions and length of stay. Cross-sectional observations were performed using the Fisher exact test, Mann–Whitney U-test, or one-way ANOVA. We performed a COX multivariable analysis to identify independent variables associated with mortality at 30 and 90 days as well as the readmission risk. Results: Data were collected from 98 patients in a four-month period. 23.5% of patients were deemed frail. 79% of all patients underwent abdominal surgery. Univariate analyses showed that polypharmacy, multimorbidity, a history of falls, hearing impairment and urinary incontinence were statistically significantly different between the non-frail and the group. Frail patients showed a higher incidence for mortality within 30 days (9% versus 1.3% (p = .053)). There were no differences between the two groups for mortality at 90 days, readmission, length of stay and operation. Frailty was a predictor for mortality at 90 days (p= .025) (hazard ratio (HR) 10.83 (95%CI 1.34–87.4)). Operation (p= .084) (HR 0.16 (95%CI 0.16–1.29)) and the presence of chronic cardiac failure (p= .049) (HR 0.38 (95%CI 0.14–0.99)) were protective for mortality at 90 days. Conclusion: Frailty is a significant predictor for mortality for elderly patients undergoing emergency abdominal/general surgery.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General)
Publisher:	Taylor & Francis
ISSN:	0001-5458
Date of First Compliant Deposit:	7 December 2017
Date of Acceptance:	27 May 2017
Last Modified:	13 Nov 2024 19:15
URI:	https://orca.cardiff.ac.uk/id/eprint/107444

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