Development and Validation of a Preoperative Frailty Index Using Health Administrative Data

Study Overview
=================
Brief Summary
-----------------
The investigators will create a frailty index using health administrative data available for older people having surgery. The index will be based on the Canadian Study of Health and Aging Frailty Index and standard recommendations for creation of frailty indices.

Detailed Description
-----------------
The investigators will create a frailty index using health administrative data available for older people having surgery. The index will be based on the Canadian Study of Health and Aging Frailty Index and standard recommendations for creation of frailty indices. Once derived the index will be tested to measure its association with outcomes, as well as its discrimination. Various representations of the frailty index will be tested (primary-as a continuous measure; secondary as a binary, categorical and fractional polynomial variable). Performance in subgroups will also be evaluated,

Official Title
-----------------
Creation, Evaluation and Validation of a Preoperative Frailty Index Using Health Administrative Data: a Population-based Cohort Study

Conditions
-----------------
Surgery, Frail Elderly Syndrome, Outcomes, Predictive Value of Tests

Intervention / Treatment
-----------------
* Diagnostic Test: Frailty index


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Having elective or emergency noncardiac surgery Exclusion Criteria: no provincial health insurance number

Ages Eligible for Study
-----------------
Minimum Age: 66 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Elective noncardiac surgery<br>Individuals having major noncardiac surgery following an elective hospital admission | Diagnostic Test: Frailty index<br>* A frailty index composed of variables from health administrative data that cover multi-system health issues. Deficits will be coded as present or absent, and the number of deficits present will be divided by the total number of deficits present to provide an overall score between 0-1.<br>|
| Emergency general surgery<br>Individuals having general surgery following an urgent hospital admission | Diagnostic Test: Frailty index<br>* A frailty index composed of variables from health administrative data that cover multi-system health issues. Deficits will be coded as present or absent, and the number of deficits present will be divided by the total number of deficits present to provide an overall score between 0-1.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival for one year after surgery | Still being alive (no death date) in the registered persons database | Date of surgery to 365 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Institutional discharge | Discharge to long term care or continuing care facility at the time of hospital discharge | Date of surgery to date of hospital discharge, or up to one year after surgery (whichever comes first) |