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Frailty Assessment Predicts Acute Outcomes in Patients Undergoing Screening Colonoscopy
Sasha Taleban1,2, Nima Toosizadeh3,4,5, Shilpa Junna3
1College of Medicine, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ, 85718, USA. staleban@deptofmed.arizona.edu.
Digestive Diseases and Sciences
|May 26, 2018
Summary
Frailty assessment effectively predicts adverse outcomes during colonoscopy in older adults, outperforming age and comorbidity indices. Routine frailty screening can improve risk stratification for patients undergoing this common endoscopic procedure.
Area of Science:
- Gerontology
- Gastroenterology
- Clinical Medicine
Background:
- Colonoscopy, a key colorectal cancer screening tool, carries risks, especially for an aging population.
- Existing methods for assessing patient risk before colonoscopy are limited.
- Frailty, a decline in physiological function, is known to predict surgical risks but its role in endoscopy is not well understood.
Purpose of the Study:
- To evaluate the effectiveness of frailty assessment in predicting adverse events during colonoscopy.
- To compare the predictive power of frailty against traditional risk factors like age and comorbidity indices.
Main Methods:
- A prospective cohort study enrolled 99 adults aged 50 years and older undergoing screening colonoscopy.
- Frailty was measured using a validated 20-second upper-extremity frailty test.
- Data on demographics, American Society of Anesthesiologists (ASA) status, Charlson Comorbidity Index (CCI), and adverse events were collected and analyzed.
Main Results:
- Of 99 participants, 50 were pre-frail/frail, and 55 experienced 87 adverse events.
- Frailty status (p=0.01) and ASA status (p=0.02) were significant predictors of colonoscopy adverse events.
- Neither age nor CCI predicted colonoscopy outcomes in this cohort.
Conclusions:
- Frailty status is a stronger predictor of colonoscopy outcomes in older adults than age or CCI.
- Routine frailty screening should be considered for risk stratification in patients undergoing colonoscopy.
- Further research is needed to fully elucidate the role of frailty in predicting endoscopic adverse events.
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