H. H. Garzon1, C. Restrepo1, E. L. Espitia1, L. Torregrosa1, L. C. Dominguez1 1Pontificia Universidad Javeriana – Hospital Universitario San Ignacio,Surgery,Bogota, , Colombia
Introduction: The association between frailty and worse outcomes in urgent abdominal surgery has not been completely evaluated. There is no information in Colombia. The objective of this study is to establish the relation between frailty, mortality, morbidity and readmission rates confined to the first 30th postoperative days, in a prospective cohort of elderly patients undergoing urgent abdominal surgery.
Methods: The Canadian Study of Health and Aging Frailty Scale (CSHA) was applied at admission to the emergency room to elderly patients (>65 years). We determinate the association between CHSA frailty scale, demographic, clinical and surgical factors with the probability of complications, death and readmission by Chi-square and Fisher’s exact tests. Multivariate analyses were conducted to identify the independent association of previous significant factors with major outcomes. Survival analysis was performed by Kaplan-Meier analysis with a log-rank test.
Results:A total of 300 consecutive patients fulfilled the inclusion criteria and were included. The global mortality rate was 14% (42 patients), the morbidity rate was 27.6% (83 patients) and the readmission rate was 15.67% (47 patients). Fifteen percent presented a frailty degree (CSHA Frailty Scale>5). The main independent factor associated to mortality was the CSHA Frailty Scale>5 (OR:4,49 p<0,001). The main independent factors associated with morbidity were the CSHA Frailty Scale>5 (OR:2,78 p<0,014) and LoS>12 days (OR:6,83 p<0,001). The independent factors associated to readmission were malnutrition (OR:1.97 p<0,04) and previous major surgery (OR:2.27 p<0,04).
Conclusion:Surgical frailty is associated to postoperative morbidity and mortality in urgent abdominal surgery in the elderly population. This association was not demonstrated with the readmission. Additional interventions are needed to control this factor in the perioperative period, which must be evaluated in new studies.