Frailty Predicts Failure to Rescue after Thoracoabdominal Operation

Journal of the American College of Surgeons
Catalina MosqueraTimothy L Fitzgerald

Abstract

An association between frailty and mortality exists; we hypothesized this is secondary to failure to rescue (F2R). Data were obtained from the NSQIP (2005 to 2012) for patients undergoing thoracoabdominal operations. Using the Modified Frailty Index, patients were classified as not (0 points), mildly (1 point), moderately (2 points), and severely (≥3) frail. There were 962,913 patients included; a majority were non-frail (52.2%), followed by mildly frail (33.8%). Complications were noted in 15.3%, major complications in 9.5%, mortality in 1.8%, and F2R in 1.3% of patients. On multivariate analysis, increases in frailty were associated with an increase in the risk of major complications (mildly: risk ratio [RR] 1.51; moderately: RR 2.69; and severely frail: RR 5.63 compared with non-frail; p < 0.0001), and death (mildly frail: RR 1.84; moderately frail: RR 4.44; and severely frail: RR 12.4). On univariate analysis, older patients, males, those undergoing small bowel interventions, gastric operations, or other procedures, and the frail were more likely to experience F2R (p < 0.0001). On multivariate analysis, males (RR 1.07), those undergoing small bowel intervention (RR 1.91), gastric operation (RR 1.83), and other procedures (R...Continue Reading

Citations

Sep 1, 2020·The Annals of Thoracic Surgery·Krish C DewanEdward G Soltesz
Mar 24, 2021·BMJ Open·Gemma F SpiersBarbara Hanratty
Jun 21, 2021·The Journal of Thoracic and Cardiovascular Surgery·Subhasis ChatterjeeJoseph S Coselli
Jun 22, 2020·The Journal of Thoracic and Cardiovascular Surgery·Nicholas J GoelNimesh D Desai

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