Journal of Multidisciplinary Healthcare (Sep 2021)
Frailty and Adverse Outcomes Among Older Patients Undergoing Gastroenterological Surgery in Vietnam
Abstract
The Ngoc Ha Than,1,2 Thien Nguyen,3 Tran To Tran Nguyen,1,4 Tai Pham4,5 1Department of Geriatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 2Department of Geriatrics-Palliative Care, Ho Chi Minh City University Medical Center, Ho Chi Minh City, Vietnam; 3Department of Cardiology, 115 People’s Hospital, Ho Chi Minh City, Vietnam; 4Department of Geriatrics, Gia Dinh People’s Hospital, Ho Chi Minh City, Vietnam; 5Department of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VietnamCorrespondence: Tran To Tran Nguyen Tel +84 979635889Email [email protected]; [email protected]: With the ageing population, more older adults undergo surgery, and frailty increases the risk of postoperative complications in older patients. This study aimed to determine the association between frailty and 30-day adverse outcomes in older patients undergoing gastroenterological surgery in Vietnam.Patients and Methods: A prospective cohort study was conducted in the Gastroenterology Department of the University Medical Center in Ho Chi Minh City. Frailty was determined using Fried’s criteria. Adverse outcomes within 30 days of gastroenterological surgery were recorded, including postoperative infections, acute respiratory failure, acute kidney injury, and death. Univariate and multivariate logistic analyses were performed to determine the association between frailty and 30-day postoperative adverse outcomes using Stata 14.0.Results: Data of 302 elective surgical participants were collected (mean age: 69.8± 8.1 years, 53.3% female), and the prevalence of frailty was 18.5%. Frailty was an independent risk factor for 30-day adverse outcomes (odds ratio=6.56, 95% confidence interval, 2.77– 15.53, p< 0.001), which included postoperative infections, acute respiratory failure, acute kidney injury, and death. Frail participants had a significantly higher risk of postoperative infections (odds ratio=8.21, 95% confidence interval, 3.28– 20.54, p< 0.001), and exhaustion was strongly associated with postoperative adverse outcomes.Conclusion: Frailty was a predictor of 30-day adverse outcomes in older patients undergoing gastroenterological surgery. Therefore, preoperative frailty should be screened in older patients, and frailty-associated risks should be considered during the decision-making process by physicians, patients, and their families.Keywords: surgical risk factors, Fried’s criteria, postoperative complications, geriatrics, infections
