• Eur J Trauma Emerg Surg · Oct 2022

    Long-term influence of frailty in elderly patients after surgical emergencies.

    • Sánchez ArteagaAlejandroAhttp://orcid.org/0000-0002-0875-7185Department of Gastrointestinal Surgery, Universitary Hospital Virgen del Rocío, Hiniesta 11, 2b, 41003, Seville, Spain. alejandros.arteaga@gmail.com., Tinoco GonzálezJoséJDepartment of Gastrointestinal Surgery, Universitary Hospital Virgen del Rocío, Hiniesta 11, 2b, 41003, Seville, Spain., Tallón AguilarLuisLDepartment of Gastrointestinal Surgery, Universitary Hospital Virgen del Rocío, Hiniesta 11, 2b, 41003, Seville, Spain., Gregorio Anguiano Díaz, Rosa María Jiménez-Rodriguez, Ana Rovira Liarde, Pareja CiuróFelipeFAcute Care Surgery Department, Universitary Hospital Virgen del Rocío, Seville, Spain., and Padillo RuízJavierJDepartment of Gastrointestinal Surgery, Universitary Hospital Virgen del Rocío, Hiniesta 11, 2b, 41003, Seville, Spain..
    • Department of Gastrointestinal Surgery, Universitary Hospital Virgen del Rocío, Hiniesta 11, 2b, 41003, Seville, Spain. alejandros.arteaga@gmail.com.
    • Eur J Trauma Emerg Surg. 2022 Oct 1; 48 (5): 3855-3862.

    PurposeFrailty is known to increase vulnerability to stressful factors, and motivate a higher morbidity and mortality in several health conditions. However, long-term impact of frailty after surgical procedures remains unclear. The purpose of this study was to evaluate the relationship between frailty and long-term clinical outcomes after emergency surgery.MethodsProspective cohort study in patients older than 70 years undergoing emergency procedures. A total of 82 patients (mean age 78.5 years, 53.3% women) were consecutively enrolled. Data on demographics, surgical procedures, complications after 30 postoperative days, and frailty according to the clinical frailty scale, Triage Risk Screening Tool (TRST), and FRAIL scale were recorded. Readmission, mortality, and transition to frailty rates were analyzed at 6 and 18 months postoperatively.ResultsThe prevalence of frailty ranged between 14.6 and 29.6% depending on the scale used. The overall mortality rate at 18 months was 19.5% (16 patients), and the survival curves demonstrated a significant difference in mortality between frail and non-frail patients assessed using the FRAIL scale and TRST (p = 0.049 and p = 0.033, respectively), with a hazard ratio of 2.28 (95% confidence interval 1.24-6.44). Logistic regression analysis showed that diabetes (p = 0.013) was an independent risk factor for transition to frailty, and antidepressant drug use was close to statistical significance (p = 0.08).ConclusionFrailty is a predictive marker of long-term mortality in patients undergoing emergency procedures. Diabetes and depression may represent independent risk factors for transition to frailty over time.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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