• Monidipa Dasgupta, Darryl B Rolfson, Paul Stolee, Michael J Borrie, and Mark Speechley.
• Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine, University of Western Ontario, Room A3-125, St. Josephs Healthcare Centre, 268 Grosvenor Road, London, Ontario N6A 4V2, Canada. monidipa.Dasgupta@sjhc.london.on.ca
• Arch Gerontol Geriatr. 2009 Jan 1;48(1):78-83.

AbstractWe sought to test whether frailty may be predictive of operative risk in older adults with medical problems. One hundred and twenty-five patients at least 70 years of age had a previously developed frailty screen, the Edmonton Frail Scale (EFS), administered at a pre-surgical clinic, prior to elective non-cardiac surgery. A blinded chart audit assessed for postoperative medical complications, length of stay and inability to be discharged home. The mean age of patients was 77 (range 70-92) and most (82%) underwent orthopedic procedures. Increasing frailty was associated with postoperative complications (p=0.02), increased length of hospitalization (p=0.004) and inability to be discharged home (p=0.01), independent of age. EFS scores of 3 or less were associated with a lower risk of having a complication (age-adjusted OR 0.27, 95% CI 0.09-0.80, likelihood ratio of 0.33) and a higher chance (80%) of being discharged home (p<0.02). EFS scores exceeding 7 were associated with increased complications (OR 5.02, 95% CI 1.55-16.25, likelihood ratio of 3.9) and a lower chance of being discharged home (40%, p<0.02). This study suggests that a frailty screen can refine risk estimates of postoperative complications in older adults undergoing elective non-cardiac surgery.

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