Cited by 513Frailty in Older AdultsCardiac, Anesthesia and Surgical OutcomesNutrition and Health in Aging

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Simple frailty score predicts postoperative complications across surgical specialties

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Robinson, Thomas N., Wu, Daniel S., Pointer, Lauren, Dunn, Christina L., Cleveland, Joseph C., Moss, Marc·2013·The American Journal of Surgery

DOI 10.1016/j.amjsurg.2013.03.012PMC PMC3788864

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Abstract

Background Our purpose was to determine the relationship between preoperative frailty and the occurrence of postoperative complications after colorectal and cardiac operations.Methods Patients 65 years or older undergoing elective colorectal or cardiac surgery were enrolled. Seven baseline frailty traits were measured preoperatively: Katz score less than or equal to 5, Timed Up and Go test greater than or equal to 15 seconds, Charlson Index greater than or equal to 3, anemia less than 35%, Mini-Cog score less than or equal to 3, albumin less than 3.4 g/dL, and 1 or more falls within 6 months. Patients were categorized by the number of positive traits as follows: nonfrail: 0 to 1 traits, prefrail: 2 to 3 traits, and frail: 4 or more traits.Results Two hundred one subjects (age 74 ± 6 years) were studied. Preoperative frailty was associated with increased postoperative complications after colorectal (nonfrail: 21%, prefrail: 40%, frail: 58%; P = .016) and cardiac operations (nonfrail: 17%, prefrail: 28%, frail: 56%; P < .001). This finding in both groups was independent of advancing age. Frail individuals in both groups had longer hospital stays and higher 30-day readmission rates. Receiver operating characteristic curves examining frailty's ability to forecast complications were colorectal (.702, P = .004) and cardiac (.711, P < .001).Conclusions A simple preoperative frailty score defines older adults at higher risk for postoperative complications across surgical specialties.

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Additional file 4 of A cohort study investigating the relationship between patient reported outcome measures and pre-operative frailty in patients with operable, non-palliative colorectal cancer
Knight, J., Ayyash, K., Colling, K., Dhesi, J. K., Ewan, V. C., Danjoux, G., Kothmann, E., Mill, A., Taylor, S., Yates, D., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12885671
Additional file 2 of Frailty and pre-frailty in cardiac surgery: a systematic review and meta-analysis of 66,448 patients
Lee, J. A., Yanagawa, B., An, K. R., Arora, R. C., Verma, S., & Friedrich, J. O. (2021) · Figshare · doi:10.6084/m9.figshare.14850904
Additional file 1 of Frailty index is useful for predicting postoperative morbidity in older patients undergoing gastrointestinal surgery: a prospective cohort study
Gu, C., Lu, A., Lei, C., Wu, Q., Zhang, X., Wei, M., & Wang, Z. (2022) · Figshare · doi:10.6084/m9.figshare.19185770
Additional file 1 of Frailty and pre-frailty in cardiac surgery: a systematic review and meta-analysis of 66,448 patients
Lee, J. A., Yanagawa, B., An, K. R., Arora, R. C., Verma, S., & Friedrich, J. O. (2021) · Figshare · doi:10.6084/m9.figshare.14850898
Additional file 3 of A cohort study investigating the relationship between patient reported outcome measures and pre-operative frailty in patients with operable, non-palliative colorectal cancer
Knight, J., Ayyash, K., Colling, K., Dhesi, J. K., Ewan, V. C., Danjoux, G., Kothmann, E., Mill, A., Taylor, S., Yates, D., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12885668
Additional file 1 of Application of MFI-5 in severe complications and unfavorable outcomes after radical resection of colorectal cancer
Huang, L., Li, Z., Jian, M., Wu, X., Chen, H., Qin, H., Li, Z., Song, S., Xie, Y., & Chen, R. (2023) · Figshare · doi:10.6084/m9.figshare.24202588
Additional file 1 of A cohort study investigating the relationship between patient reported outcome measures and pre-operative frailty in patients with operable, non-palliative colorectal cancer
Knight, J., Ayyash, K., Colling, K., Dhesi, J. K., Ewan, V. C., Danjoux, G., Kothmann, E., Mill, A., Taylor, S., Yates, D., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12885662
Additional file 2 of A cohort study investigating the relationship between patient reported outcome measures and pre-operative frailty in patients with operable, non-palliative colorectal cancer
Knight, J., Ayyash, K., Colling, K., Dhesi, J. K., Ewan, V. C., Danjoux, G., Kothmann, E., Mill, A., Taylor, S., Yates, D., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12885665
Additional file 1 of A prospective cohort study evaluating screening and assessment of six modifiable risk factors in HPB cancer patients and compliance to recommended prehabilitation interventions
van Wijk, L., van der Snee, L., Buis, C. I., Hentzen, J. E. K. R., Haveman, M. E., & Klaase, J. M. (2021) · Figshare · doi:10.6084/m9.figshare.14052510
Perioperative characteristics and outcomes of colorectal cancer in elderly patients
Sultan, A., Zakaria, Z., Riaz, S., Goni, M. D., & Zakaria, A. D. (2026) · World Journal of Gastrointestinal Surgery · doi:10.4240/wjgs.v18.i1.113040

Authors: Robinson, T. N., Wu, D. S., Pointer, L., Dunn, C. L., Cleveland, J. C., & Moss, M.
Affiliations: Denver VA Medical Center (US)
University of Colorado Anschutz (US)
Corresponding author: Robinson, Thomas N.
ORCID: Pointer, Lauren
Cleveland, Joseph C.
Venue: The American Journal of Surgery
Publisher: Elsevier BV
Published: 2013-10
Volume: 206
Issue: 4
Pages: 544-550
ISSN: 0002-9610 (ISSN-L)
DOI: 10.1016/j.amjsurg.2013.03.012
PMC: PMC3788864
OpenAlex: W2154467062
Semantic Scholar: a727e37222039387bda0b9af689322fa73c11e91
Cited by: 513
References: 30
Citations by year: 2026: 19 · 2025: 24 · 2024: 36 · 2023: 41 · 2022: 34 · 2021: 47 · 2020: 66 · 2019: 49 · 2018: 40 · 2017: 50 · 2016: 48 · 2015: 31 · 2014: 27
FWCI: 16.32
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Surgery (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (K23AG034632)
National Heart, Lung, and Blood Institute (K24HL089223)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Keywords: preoperative frailty, frailty score, postoperative complications, colorectal surgery, cardiac surgery, older adults, preoperative assessment, length of hospital stay, 30-day readmission, fall history, anemia, albumin, cognitive impairment
MeSH terms: Aged, Colon, Female, Humans, Length of Stay, Male, Patient Readmission, Postoperative Complications, Prospective Studies, Rectum, ROC Curve, Cardiovascular Surgical Procedures, Digestive System Surgical Procedures, Geriatric Assessment, Logistic Models, Frail Elderly, Risk Assessment

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Simple frailty score predicts postoperative complications across surgical specialties

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