Frailty and Post-operative Complications in Older Surgical Patients: The Implication of Frailty and Preoperative Risk Assessment

Study Overview
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Brief Summary
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Frailty is prevalent in older adults and may be a better predictor of post-operative morbidity and mortality than chronological age. Preoperative risk factors and physiological reserves were assessed on patients more than 70 years old who are scheduled for surgery under general or regional anesthesia. The aim of this retrospective analysis was to examine the impact of relevant geriatric assessments on adverse outcomes in older surgical patients.

Detailed Description
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The goal of this study is to analyze the effect of frailty status on postoperative outcomes. These include postoperative complications (only ICD-10 coded diagnoses), length of hospitalization (ward/ICU), disposition, and survival. The project will also attempt to find synergism between a positive frailty status and common medical conditions (e.g. diabetes, congestive heart failure, coronary artery disease, dementia, and kidney disease), as well as anesthesiological and surgical processes (e.g. duration and type of anesthesia, surgical risk, and surgical discipline). Different assessment tools will be analyzed regarding their predictive power and clinical practicability. This should help improve preoperative risk assessment and allow for the multidimensional (physical, cognitive, social) identification of relevant frailty characteristics in the perioperative setting. All outcome parameters, including admission and discharge periods, will be collected using coded information from our hospital database. There will be no follow-up measurements after hospital discharge.

Official Title
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Frailty and Post-operative Complications in Older Surgical Patients: The Implication of Frailty and Preoperative Risk Assessment - A Retrospective Analysis

Conditions
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Frailty, Surgery, Older Patients

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and female patients with age 70 years and above scheduled for surgery in the Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Older robust surgical patients<br>Male and female patients with age 65 years and above scheduled for surgery, which are robust according to Fried's Modified Frailty Score. | |
| Older pre-frail surgical patients<br>Male and female patients with age 65 years and above scheduled for surgery, which are pre-frail according to Fried's Modified Frailty Score. | |
| Older frail surgical patients<br>Male and female patients with age 65 years and above scheduled for surgery, which are frail according to Fried's Modified Frailty Score. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative complications | ICD-10 coded diagnoses for the hospitalization | 06/2016-12/2022 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of Hospital stay |  | 06/2016-12/2022 | 
| Duration of Intensive Care Unit Stay |  | 06/2016-12/2022 | 
| Procedures | The procedures are measured regarding the following practices: anesthesiological, surgical, physiotherapeutic, social, cognitive, therapeutic, behavioral | 06/2016-12/2022 | 
| Morbidity |  | 06/2016-12/2022 | 
| Ventilation | Ventilation is measured in hours. | 06/2016-12/2022 | 
| Requirements for intensive care unit |  | 06/2016-12/2022 | 
| Intensive care unit scores |  | 06/2016-12/2022 | 
| Disease severity |  | 06/2016-12/2022 | 
| Postoperative Delirium | Delirium is measured with validated delirium scores. | 06/2016-12/2022 | 
| Mortality | Mortality is measured in hospital. | 06/2016-12/2022 | 
| Medical costs | Costs incurred during hospitalization | 06/2016-12/2022 | 
| Physiotherapy | Physiotherapy is measured by Physiotherapists support. | 06/2016-12/2022 | 
| Nutritional therapy 1 | Nutritional consultations | 06/2016-12/2022 | 
| Nutritional therapy 2 | Feeding | 06/2016-12/2022 | 
| Post - intensive care syndrome | Post - Intensive care syndrome is measured by a cluster of symptoms that are unique to the Intensive care unit environment. | 06/2016-12/2022 |