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Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
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Predicting outcomes in older patients undergoing vascular surgery using the Hospital Frailty Risk Score.

S J Aitken1,2,3, S Lujic4, D A Randall5

  • 1Concord Clinical School, Camperdown, Australia.

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|June 22, 2021
PubMed
Summary

The Hospital Frailty Risk Score (HFRS) effectively predicts mortality and hospital use in older patients undergoing vascular surgery. Incorporating HFRS improves risk assessment for 2-year mortality and prolonged hospital stays.

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Area of Science:

  • Geriatric Medicine
  • Vascular Surgery
  • Health Services Research

Background:

  • Frailty is a significant risk factor for adverse outcomes in older adults undergoing vascular surgery.
  • The Hospital Frailty Risk Score (HFRS) categorizes frailty into low, intermediate, and high risk using administrative data.

Purpose of the Study:

  • To evaluate the predictive accuracy of the HFRS for mortality and hospital utilization in elderly patients undergoing vascular surgery.
  • To determine if HFRS improves risk prediction models for surgical outcomes.

Main Methods:

  • Analysis of routinely collected hospital data and death records for patients aged 75+ undergoing vascular surgery (2010-2012) in New South Wales, Australia.
  • Multilevel logistic regression models were employed to compare outcomes, adjusting for patient and procedural factors, with and without frailty assessment using HFRS.

Main Results:

  • 17.6% of 9752 patients had a high-risk HFRS.
  • High-risk frailty was associated with a 4.15-fold increased odds of 30-day mortality and a 4.27-fold increased odds of 2-year mortality.
  • HFRS addition improved prediction of 2-year mortality and prolonged hospital stay, with minimal impact on 30-day mortality and readmission.

Conclusions:

  • Adjusting for HFRS in risk prediction models enhances the discrimination of outcomes for older patients undergoing vascular surgery.
  • HFRS is a valuable tool for identifying high-risk patients in this population, aiding clinical decision-making and resource allocation.