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Related Concept Videos

Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...

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Identifying Frailty Using Point-of-Care Ultrasonography: Image Acquisition and Assessment
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Published on: July 26, 2024

Does Chronological Age Adequately Stratify Perioperative Risk? A Prospective Multicenter Cohort Study Using Frailty

Sergii Girnyi1, Virginia Boccardi2, Elena Montanari3

  • 1Department of General Surgery and Surgical Oncology, "Saint Wojciech" Hospital, "Nicolaus Copernicus" Health Center, 80462 Gdańsk, Poland.

Journal of Clinical Medicine
|June 12, 2026
PubMed
Summary
This summary is machine-generated.

Chronological age is a poor predictor of surgical outcomes. Functional assessments like frailty status and handgrip strength (HGS) better identify patients at risk for prolonged hospitalization after abdominal surgery.

Keywords:
abdominal surgeryfrailtyhandgrip strengthlength of stayperioperative risk stratification

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Area of Science:

  • Geriatric Medicine
  • Surgical Outcomes Research
  • Perioperative Medicine

Background:

  • Chronological age is commonly used in perioperative risk assessment but doesn't fully capture individual patient vulnerability.
  • Patients of similar chronological age often have different postoperative outcomes, suggesting physiological reserve is crucial.
  • The study investigates if functional phenotyping is superior to age alone in predicting surgical risk.

Purpose of the Study:

  • To compare the discriminatory performance of chronological age versus functional phenotyping (frailty and handgrip strength) in predicting prolonged hospitalization after elective abdominal surgery.
  • To determine if frailty status and handgrip strength (HGS) better reflect physiological reserve than chronological age alone.
  • To assess the independent association of frailty and chronological age with prolonged length of stay (LOS).

Main Methods:

  • Prospective, multicenter observational cohort study of 223 adults undergoing elective abdominal surgery.
  • Patients were assessed using chronological age, frailty phenotype (fit, pre-frail, frail), and baseline handgrip strength (HGS).
  • Prolonged hospitalization (LOS > 10 days) was the primary outcome; analyses included cross-classification, logistic regression, and ROC curves.

Main Results:

  • Significant discordance exists between chronological age and frailty status, with frail patients found across all age groups.
  • Frailty status, not chronological age, was independently associated with prolonged hospitalization (LOS > 10 days).
  • Frailty phenotype (AUC 0.679) and a combined model (AUC 0.810) showed better discrimination for prolonged LOS than chronological age (AUC 0.579).

Conclusions:

  • Chronological age alone has limited discriminatory power for perioperative risk stratification in abdominal surgery.
  • Functional phenotyping, incorporating frailty status and objective measures like HGS, offers a more accurate assessment of physiological reserve.
  • Individualized, function-centered perioperative assessment is recommended for better patient outcomes.