FRAILTY AND POSTOPERATIVE OUTCOMES IN PATIENTS AGED ≥80 YEARS UNDERGOING EMERGENCY ABDOMINAL SURGERY

The number of patients aged ≥80 years undergoing emergency abdominal surgery is increasing. Although frailty has been associated with adverse surgical outcomes, its impact in this population remains insufficiently characterized. We aimed to describe the clinical and frailty characteristics of this population and identify factors associated with postoperative complications and mortality.

We conducted a prospective single-center cohort study including consecutive patients aged ≥80 years undergoing emergency abdominal surgery between September 2018 and March 2023. Frailty was assessed using the Clinical Frailty Scale (CFS). Functional status (Barthel Index), cognitive impairment (GDS-R), nutritional status (MNA-SF), comorbidity burden (CIRS-G), serum albumin, and postoperative outcomes were assessed. Surgical complications were graded according to the Clavien-Dindo classification.

A total of 178 patients were included (mean age, 86.1 years; 24.7% nonagenarians). Surgical complications occurred in 38.4%, medical complications in 76.1%, and major complications (Clavien-Dindo ≥III) in 107 (71.3%). In-hospital mortality was 6.2%. Hypoalbuminemia was associated with surgical complications. Medical complications were associated with functional dependence, cognitive impairment, malnutrition risk, hypoalbuminemia, and frailty. Major complications were associated with functional dependence, cognitive impairment, hypoalbuminemia, and frailty. Frailty was not associated with 12-month mortality or 30-day Emergency Department visits.

Frailty is associated with postoperative medical complications and their severity in patients aged ≥80 years undergoing emergency abdominal surgery. Functional dependence and hypoalbuminemia identify high-risk patients who may benefit from multidisciplinary geriatric co-management.