Influence of frailty in the outcome of surgical patients over 70 years old with admission criteria in ICU.

Abstract:

INTRODUCTION:Frailty degree can influence more than age or severity in the outcome of patients older than 70 years undergoing surgery of the digestive system that require immediate postoperative control in the ICU. METHODS:A prospective and observational study of patients over 70 years of age who were admitted to the surgical ICU of a third level hospital immediately after an elective or emergent surgical intervention on the digestive system from June 1, 2018 until June 1, 2019. The variables age, frailty Clinical Frailty Scale (CFS), and modified Frailty Index (mFI), severity (APACHE II), type of surgery, surgical pathology were recorded upon admission. A bivariate analysis was performed to assess the influence of frailty and severity on hospital morbidity and mortality and baseline situation of the patient (in terms of dependence) at 6 months. RESULTS:A total of 90 patients were recruited, 54.4% of whom were reoperated; 74.4% were initially discharged from the ICU, with 28.4% of readmission and directly associated to frailty (CFS and mFI: P<0.01). The overall mortality at 6 months was 44.5% being CFS (OR = 64.3; P<0.05, 95% CI: 12.3-333.9) and APACHE II (OR = 1.17; P<0.05; 95% CI: 1.04-1.32) the covariates that best related. CONCLUSIONS:The estimation of frailty by CSF and mFI is directly associated to the surgical morbidity and readmission of elderly and severe patients admitted to the ICU. In addition, CFS and mFI has been efficient as a predictive of mortality at 6 months.

journal_name

Cir Esp

journal_title

Cirugia espanola

authors

Ruiz de Gopegui Miguelena P,Martínez Lamazares MT,Miguelena Hycka J,Claraco Vega LM,Gurpegui Puente M

doi

10.1016/j.ciresp.2020.04.022

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

41-48

issue

1

eissn

0009-739X

issn

1578-147X

pii

S0009-739X(20)30159-7

journal_volume

99

pub_type

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