RESULTS Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications .
These relationships emerge in different type of surgical procedures and patients ' features .
BACKGROUND Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve .
The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals .
Risk adjustment of the postoperative morbidity rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study.
BACKGROUND The National Veterans Affairs Surgical Risk Study was design ed to collect reliable , valid data on patient risk and outcomes for major surgery in the Veterans Health Administration and to report comparative risk-adjusted postoperative mortality and morbidity rates for surgical services in the Veterans Health Administration . STUDY DESIGN This was a cohort study conducted at 44 Veterans Affairs Medical Centers closely affiliated with university medical centers . Included were 87,078 major noncardiac operations performed under general , spinal , or epidural anesthesia between October 1 , 1991 , and December 31 , 1993 . The main outcomes measures in this report are 21 postoperative adverse events ( morbidities ) occurring within 30 days after the index procedure . Multivariable logistic regression risk-adjustment models for all operations and for eight surgical subspecialties were developed . RESULTS Patient risk factors predictive of postoperative morbidity included serum albumin level , American Society of Anesthesia class , the complexity of the operation , and 17 other preoperative risk variables . Wide variation in the unadjusted rates of one or more postoperative morbidities for all operations was observed across the 44 hospitals ( 7.4 - 28.4 % ) . Risk-adjusted observed-to-expected ratios ranged from 0.49 to 1.46 . The Spearman rank order correlation between the ranking of the hospitals based on unadjusted morbidity rates and risk-adjusted observed-to-expected ratios for all operations was 0.87 . There was little or no correlation between the rank order of the hospitals by risk-adjusted morbidity and risk-adjusted mortality . CONCLUSIONS The Department of Veterans Affairs has successfully implemented a system for the prospect i ve collection and comparative reporting of postoperative mortality and morbidity rates after major noncardiac operations . Risk adjustment had only a modest effect on the rank order of the hospitals
RESULTS Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications .
These relationships emerge in different type of surgical procedures and patients ' features .
BACKGROUND Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve .
The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals .