Saucedo MEM, Fernández RE, Ricárdez GJA, García MLE, Gaona RF, Chimal JMF

Language: Spanish
References: 12
Page: 327-332
PDF size: 170.80 Kb.

ABSTRACT

Objective: Identifying if the FRAIL index is useful as a predictor of post-surgical complications in patients other than 65 years. Material and methods: We studied a sample of 60 patients older than 65 years operated for acute conditions. We all applied the FRAIL index prior to the surgical event to identify those patients who are fragile and non-fragile. We evaluate and compare complications and mortality between each group by objectively with the comprehensive complication index (CCI) test. Results: The mean preoperative FRAIL index was 1.82 ± 0.983. The 21.6% were fragile. The 41.7% of the patients had serious complications. We identified that there is a four times higher risk of presenting major complications (ICC ≥ 25) in patients with fragility vs non-fragile patients, OR = 4.479 (95% CI 1.13 to 17.73, p = 0.033). Conclusion: The FRAIL index is an easy and usable tool to identify those with fragility syndrome in a timely manner, who are at four times the risk of post-surgical complications.

REFERENCES

1. An aging nation: The older population in the United States; Currente population reports 2014. Current Population Reports Internet. Washington, DC: US Census Bureau, Population Projections Branch. Disponible en: https://www.census.gov/library/publications/2014/demo/p25-1140.html

2. Base de datos INEGI [Internet]. Encuesta Nacional de la Dinámica Demográfica SNEGI; 2018. [Actualizado 30 de septiembre de 2019] Disponible en: https://www.inegi.org.mx/contenidos/saladeprensa/aproposito/2019/edad2019_Nal.pdf

3. Kim SW, Han HS, Jung HW, Kim KI, Hwang DW, Kang SB et al. Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA Surg. 2014; 149 (7): 633-640.

4. Joseph B, Zangbar B, Pandit V, Kulvatunyou N, Haider A, O'Keeffe T et al. Mortality after trauma laparotomy in geriatric patients. J Surg Res. 2014; 190 (2): 662-666.

5. Joseph B, Zangbar B, Pandit V, Fain M, Mohler MJ, Kulvatunyou N et al. Emergency general surgery in the elderly: too old or too frail? J Am Coll Surg. 2016; 222 (5): 805-813.

6. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56 (3): M146-M156.

7. Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014; 9: 433-441.

8. Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013; 14 (6): 392-397.

9. Saucedo-Moreno EM, Fenig-Rodríguez J. Estadística en cirugía, cómo entender y aplicar conceptos básicos. Cir Cir. 2019; 87 (6): 692-697.

10. Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R et al. Frailty in older adults: a nationally representative profile in the United States. J Gerontol A Biol Sci Med Sci. 2015; 70 (11): 1427-1434.

11. Rockwood K, Andrew M, Mitnitski A. A comparison of two approaches to measuring frailty in elderly people. J Gerontol A Biol Sci Med Sci. 2007; 62 (7): 738-743.

12. Rockwood K, Mitnitski A, Song X, Steen B, Skoog I. Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc. 2006; 54 (6): 975-979.