Frail Patients Undergoing Optimization Before Surgery: Preliminary Results.

Area of Science:

• Geriatric Medicine
• Surgical Outcomes Research
• Patient Optimization

Background:

• Frailty affects over 10% of patients aged 65+, increasing surgical risks.
• The Edmonton Frailty Scale offers a reliable method for pre-surgical frailty assessment.
• Understanding frailty's impact on surgical outcomes is crucial for patient management.

Purpose of the Study:

• To investigate the correlation between Edmonton Frailty Scale scores and surgical outcomes.
• To assess the effectiveness of pre-surgical optimization in frail patients.
• To evaluate the 30-day post-operative outcomes in patients undergoing surgery.

Main Methods:

• Retrospective analysis of 138 patients assessed for frailty from September 2020 to May 2023.
• Patients received pre-surgical optimization for various health conditions.
• Outcomes included surgical progression, cancellation, and 30-day post-operative adverse events.

Main Results:

• Patients proceeding to surgery had a lower average Edmonton Frailty Scale score (7.013) compared to those with canceled/delayed surgery (9.389-9.600).
• Postoperative infection rates were below 3%.
• The 30-day emergency department and readmission rate was 21% for patients who proceeded to surgery.

Conclusions:

• Lower Edmonton Frailty Scale scores correlate with a higher likelihood of proceeding to surgery.
• Higher frailty scores are associated with increased surgical cancellation or delays.
• Frail patients cleared for surgery exhibit a substantial 30-day emergency department and readmission rate, indicating a need for targeted post-discharge support.