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Identifier

000425460

Title

Προοπτική μελέτη σύγκρισης ενδελεχούς γηριατρικής εκτίμησης και φαινότυπου της ευπάθειας σε ηλικιωμένους χειρουργικούς ασθενείς

Alternative Title

Prospective stydy comparing the comprehensive geriatric assessment and the frailty phenotype in geriatric surgical patients

Author

Ανδρέου, Αλέξανδρος

Thesis advisor

Χρυσός, Ε.

Reviewer

Χλουβεράκης, Γρηγόριος
Λασηθιωτάκης, Κ.

Abstract

Background Frailty in a surgical geriatric population may identify patients at increased risk for complications. However, the optimal method to diagnose it remains to be identified. This study aims to compare two common frailty models and assess their association with postoperative adverse outcomes in elderly patients undergoing general surgical procedures. Methods Prospective study including 298 patients age 65 years or older undergoing elective general surgical operations in a tertiary hospital. Frailty phenotype (FP) was classified using a validated scale which included weight loss, weakness, exhaustion, slowed walking speed and low physical activity. A preoperative comprehensive geriatric assessment (CGA) was performed including managing daily activities (ADL), instrumental ADL (IADL), cognitive status, co-morbidities, polypharmacy and nutritional status (MUST). Main outcomes measures were postoperative complications and length of stay. Results There were 135(46%), 114(38%) and 46(15%) minor/intermediate, major and major+ procedures, respectively. The agreement between the FP and CGA was moderate (kappa index: 0.45). FP was significantly associated with postoperative complications with an odds ratio (OR) of 2.3, (95% confidence interval: 1.4-3.8, p<0.01). The association of CGA with postoperative complications did not reach statistical significance (p=0.07). Frail patients experienced significantly longer postoperative hospital stay compared to their fit counterparts in both CGA frailty (p<0,001) and FP (p=0,001) groups. In the multivariate analysis adjusted for ASA and POSSUM category, FP retained its significance as a predictor of postoperative complications (OR: 1.9, 95%CI: 1.03-3.3, p=0.038). Conclusions FP was associated more consistently than CGA with adverse postoperative outcomes in elderly patients undergoing general surgical procedures.

Language

Greek

Subject

Postoperative complications

Ενδελεχής γηριατρική εκτίμηση

Ευπάθεια

Μετεγχειρητικές επιπλοκές

Φαινότυπος ευπάθειας

Issue date

2019-12-11

Collection

School/Department--School of Medicine--Department of Medicine--Doctoral theses