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Long-term influence of frailty in elderly patients after surgical emergencies

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Frailty is known to increase vulnerability to stressful factors, and motivate a higher morbidity and mortality in several health conditions. However, long-term impact of frailty after surgical procedures remains unclear. The purpose of this study was to evaluate the relationship between frailty and long-term clinical outcomes after emergency surgery.

Methods

Prospective cohort study in patients older than 70 years undergoing emergency procedures. A total of 82 patients (mean age 78.5 years, 53.3% women) were consecutively enrolled. Data on demographics, surgical procedures, complications after 30 postoperative days, and frailty according to the clinical frailty scale, Triage Risk Screening Tool (TRST), and FRAIL scale were recorded. Readmission, mortality, and transition to frailty rates were analyzed at 6 and 18 months postoperatively.

Results

The prevalence of frailty ranged between 14.6 and 29.6% depending on the scale used. The overall mortality rate at 18 months was 19.5% (16 patients), and the survival curves demonstrated a significant difference in mortality between frail and non-frail patients assessed using the FRAIL scale and TRST (p = 0.049 and p = 0.033, respectively), with a hazard ratio of 2.28 (95% confidence interval 1.24–6.44). Logistic regression analysis showed that diabetes (p = 0.013) was an independent risk factor for transition to frailty, and antidepressant drug use was close to statistical significance (p = 0.08).

Conclusion

Frailty is a predictive marker of long-term mortality in patients undergoing emergency procedures. Diabetes and depression may represent independent risk factors for transition to frailty over time.

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Acknowledgements

Authors acknowledge the contribution of the Gastrointestinal Surgery Department at University Hospital Virgen del Rocío, for support and full collaboration during the whole study period.

Funding

The authors declare that no funding was received in relation to this article.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Universitary Hospital Virgen del Rocío, Hiniesta 11, 2b, 41003, Seville, Spain

    Alejandro Sánchez Arteaga, José Tinoco González, Luis Tallón Aguilar, Gregorio Anguiano Díaz, Rosa María Jiménez-Rodriguez & Javier Padillo Ruíz

  2. Department of General Medicine, Universitary Hospital Virgen del Rocío, Seville, Spain

    Ana Rovira Liarde

  3. Acute Care Surgery Department, Universitary Hospital Virgen del Rocío, Seville, Spain

    Felipe Pareja Ciuró

Authors
  1. Alejandro Sánchez Arteaga
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  2. José Tinoco González
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  3. Luis Tallón Aguilar
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  4. Gregorio Anguiano Díaz
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  5. Rosa María Jiménez-Rodriguez
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  6. Ana Rovira Liarde
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  7. Felipe Pareja Ciuró
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  8. Javier Padillo Ruíz
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Corresponding author

Correspondence to Alejandro Sánchez Arteaga.

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Conflict of interest

The authors declare that they have no conflict of interest in relation to this article.

Ethical approval

The study was approved by the Ethics Committee of Hospital Universitario Virgen del Rocío. All participants granted their consent to participate in the study. All of the authors have confirmed the preservation of confidentiality and respect of patients’ rights in the document of author responsibilities, publication agreement and transfer of rights to the European Journal of Trauma and Emergency Surgery.

Additional information

The present work was carried out in the Universitary Hospital Virgen del Rocío, Seville, Spain.

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Sánchez Arteaga, A., Tinoco González, J., Tallón Aguilar, L. et al. Long-term influence of frailty in elderly patients after surgical emergencies. Eur J Trauma Emerg Surg 48, 3855–3862 (2022). https://doi.org/10.1007/s00068-021-01818-6

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  • DOI: https://doi.org/10.1007/s00068-021-01818-6

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