Automated Electronic Frailty Index-Identified Frailty Status and Associated Postsurgical Adverse Events.

Area of Science:

• Gerontology
• Health Informatics
• Surgical Outcomes

Background:

• The electronic frailty index (eFI) is an automated tool utilizing electronic health records (EHRs) to assess frailty.
• The association between eFI and postanesthesia adverse outcomes remains unevaluated.

Purpose of the Study:

• To investigate the link between frailty, determined by eFI, and adverse events following elective noncardiac surgery.
• To categorize patients as fit, prefrail, or frail based on eFI scores.

Main Methods:

• A cohort study included 33,449 patients aged 55 years or older undergoing noncardiac surgery.
• Preoperative eFI scores were calculated and categorized: fit (≤0.10), prefrail (>0.10 to ≤0.21), and frail (>0.21).
• The primary outcome was a composite of 8 adverse events, including mortality, readmission, and complications.

Main Results:

• Patients classified as prefrail (OR, 1.24) and frail (OR, 1.71) had a significantly higher likelihood of experiencing postoperative adverse events compared to fit patients.
• An increase of 0.03 units in eFI correlated with a 1.06 increased odds of composite adverse events.
• These associations remained significant after adjusting for multiple confounders.

Conclusions:

• Frailty, as measured by the automated eFI integrated into EHRs, is associated with an elevated risk of adverse events post-noncardiac surgery.
• eFI tools can potentially support screening and risk stratification, particularly for patients undergoing high-risk surgical procedures.