I.F.MINERVA1, J.Q.CHIA1, S.NATESAN1
Tan Tock Seng Hospital1
Multiple studies have shown a strong association between frailty and adverse peri-operative outcomes. We aim to determine association of frailty with adverse outcomes in patients admitted under Vascular Surgery that are comanaged with GSS.
We did a subgroup analysis of prospective cohort of 101 patients (78.2 + 6.9 years, 55.4% males). Frailty was defined using CFS grouped into 3 categories: Not frail (CFS < 4), mild- moderate frail (CFS 4-6), and severely frail (CFS 7-9). Descriptive statistics analysis for baseline characteristics and univariate analysis for adverse outcomes (post-operative complications, mortality, readmission, institutionalization) using Chi-square test for categorical date and Kruskal Wallis for nonparametric data were done.
Frailty prevalence was 98% (85.1% mild-moderate frail). Dementia prevalence was 34.7% and most patients were assisted in their pre-morbid function (49.5%) with very high weight comorbidity class (median CCI=8, IQR 7-10). 44.6% of patients underwent major vascular operations with 98% receiving peri-operative GSS intervention. Occurrence of post-operative complications increased with increasing frailty except congestive cardiac failure (all p>0.05). A similar trend was seen for 30-day mortality and institutionalization on discharge (all p>0.05). Only the mild to moderate frail group experienced 30-day readmissions (18.6%, p>0.05).
Increasing frailty was not significantly associated with adverse outcomes in our population of comanaged older surgical patients although there were increasing occurrences of these outcomes. Larger prospective studies are required to examine this relationship in the geriatric surgical population.