Frailty is a significant risk factor for postoperative complications and functional decline. Preoperative assessment of frailty is therefore recommended in all older adults. However, despite the availability of many frailty tools, few have been tested in the preoperative setting and there is little comparison of their predictive value in identifying patients at risk. The aim of this study is to investigate which of the following instruments for determining frailty has the highest predictive power with regard to the occurrence of postoperative complications: Risk Analysis Index, Clinical Frailty Scale, the Groningen Frailty Indicator, the Edmonton Frail Scale and the LUCAS-FI. The aim of this research project is to identify a suitable frailty instrument for preoperative risk stratification of older patients during the premedication visit.
Study Type
OBSERVATIONAL
Enrollment
584
This is an observational study without any intervention. Frailty is assessed using multiple tools and postoperative outcome is compared.
University Medical Centre Hamburg
Hamburg, Germany
Complications in the first 30 days after surgery
Measured by Clavien-Dindo classification
Time frame: 30 days
Functional state (activities of daily living)
Measured using WHO Disability Assessment Schedule 2.0
Time frame: one, three and six months after surgery
Postoperative Quality of Recovery
Measured by Quality-of-Recovery-15 questionnaire
Time frame: postoperative day 2
Muscle loss during hospitalisation
measured by bioimpedance prior to admission and before discharge from hospital
Time frame: From date of enrollment, up to 4 weeks after surgery
Postoperative delirium
Measured by 3D-Confusion Assessment Method
Time frame: postoperative day 1 to 5
Length of stay
days spent in hospital after surgery
Time frame: from day of surgery, up to 4 weeks after surgery
Discharge destination
e.g.:home, nursing home, other hospital
Time frame: up to 4 weeks after surgery
Cognitive state
Using 5-Minute Montreal Cognitive Assessment (telephone-MOCA). A maximum of 15 points and a minumum of 0 points can be archieved; a higher score indicates better cognitive performance.
Time frame: 3 and 6 months after surgery
Quality-of-Life (QoL)
Measured by WHO-Quality of Life in older adults (WHOQOL-OLD) questionnaire. The WHOQOL-OLD is evaluated by calculating scores for its six facets and summing them, with higher scores indicating a better perceived quality of life.
Time frame: 3 and 6 months after surgery
Frailty progression measured by LUCAS-FI
Frailty assessment with Longitudinal Urban Cohort Aging Study Functional Index (LUCAS-FI)-questionnaire (telephone interview) The LUCAS-FI is evaluated by integrating both risk factors and protective resources, with the balance between them determining the degree of frailty.
Time frame: 3 and 6 months after surgery
Frailty progression measured by GFI (questionnaire)
frailty assessment with Groningen Frailty Indicator (GFI) questionnaire (telephone interview). The GFI is evaluated by summing its item responses, with higher scores indicating a higher degree of frailty.
Time frame: 3 and 6 months after surgery
Frailty progression measured by EFS
Frailty assessment by Edmonton Frail Scale (EFS), (score filled by physician, patient telephone interview). 1 to 10 points can be archieved, more points indicate a greater level of frailty.
Time frame: 3 and 6 months after surgery
Frailty progression by RAI measurement. The Risk Analysis Index (RAI) is evaluated by summing weighted risk factors and protective variables, with higher scores indicating greater patient vulnerability.
Frailty assessment with Risk Analysis Index (index filled by physician, patient telephone interview)
Time frame: 3 and 6 months after surgery
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