Frail and very frail patients have an “alarmingly high” mortality risk following all types of surgery when compared to stronger patients, a new study has shown.
It’s known that adults diagnosed with frailty are more likely to die following high-risk surgical procedures. But this outcome is also true for lower-stress procedures, reported Myrick C. Shinall Jr., M.D., from Vanderbilt University Medical Center, Nashville.
Shinall and colleagues analyzed health data of more than 400,000 veterans hospital patients treated over four years.
Thirty days after a low-risk surgery, 1.6% of frail patients and 10.3% of very frail patients had died. In contrast, their peers who weren’t frail had a 0.22% mortality rate after low-risk surgery. Overall, the frail patients were more likely to die within 30, 90 and 180 days after surgery than their non-frail cohort.
Lower-stress surgeries included procedures such as cystoscopy (scope of the bladder) and minimally invasive gallbladder removal.
Based on the results, the researchers recommend that patients be assessed prior to surgery using the Risk Analysis Index, a validated assessment tool. Clinicians and frail patients will then be better equipped to make decisions when elective surgery is being considered, said co-author Paula Shireman, M.D., M.S., M.B.A., from UT Health San Antonio
“There is no right or wrong answer,” Shireman said. “Two patients, given the exact same scenario, could choose entirely opposite directions. Our approach has to be patient-centered.”
Frailty is a clinical syndrome that is associated with age. Its symptoms include slow walking speed, weak grip, poor balance, exhaustion and low physical activity.
Full findings appear in JAMA Surgery.
