Postoperative Recovery in Frail, Pre-frail, and Non-frail Elderly Patients Following Abdominal Surgery

被引:19
|
作者
Sikder, Tarifin [1 ,2 ]
Sourial, Nadia [1 ]
Maimon, Geva [1 ]
Tahiri, Mehdi [2 ,3 ]
Teasdale, Debby [1 ]
Bergman, Howard [1 ,4 ]
Fraser, Shannon A. [3 ]
Demyttenaere, Sebastian [2 ]
Bergman, Simon [1 ,3 ]
机构
[1] Lady Davis Inst Med Res, Montreal, PQ, Canada
[2] McGill Univ, St Marys Hosp Ctr, Montreal, PQ, Canada
[3] McGill Univ, Div Gen Surg, Dept Surg, Jewish Gen Hosp, 3755 Chemin Cote St Catherine, Montreal, PQ H3T 1E2, Canada
[4] McGill Univ, Dept Family Med, Montreal, PQ, Canada
关键词
QUALITY-OF-LIFE; OLDER-ADULTS; PREOPERATIVE FRAILTY; CENTERED-OUTCOMES; COLORECTAL-CANCER; ELECTIVE SURGERY; SURGICAL CARE; MORTALITY; COMPLICATIONS; MORBIDITY;
D O I
10.1007/s00268-018-4801-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
BackgroundThe objective of this study is to explore the association between frailty and surgical recovery over a 6-month period, in elderly patients undergoing elective abdominal surgery.MethodsA total of 144 patients were categorized as frail, pre-frail, and non-frail based on five criteria: weight loss, exhaustion, weakness, slowness, and low activity. Recovery to preoperative functional status (activities of daily living (ADL) and instrumental activities of daily living (IADL)), cognition, quality of life, and mental health was assessed at 1, 3, and 6months postoperatively. A repeated measure logistic regression was used to analyze the effect of frailty on recovery over time. The effect of frailty on hospitalization outcomes was also evaluated.ResultsMean age was 785years with 17.4% of patients categorized as frail, 60.4% pre-frail, and 22.2% non-frail. At 6months, the percent of patients who had recovered to preoperative values were: ADL 90%; IADL 76%; cognition 75.5%; mental health 66%; and quality of life 70%. While more frail patients experienced adverse hospitalization outcomes and fewer had recovered to preoperative functional status, these differences were not found to be statistically significant. Overall, frailty status was not significantly associated with the trajectory of recovery or hospitalization outcomes.Conclusion p id=Par4 Strong, institutional commitment to quality surgical care, as well as appropriate strategies for older patients, may have mitigated the impact of frailty on recovery. Further research is needed to examine the role of frailty in the surgical recovery process.
引用
收藏
页码:415 / 424
页数:10
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