Frailty as a predictor of postop mortality, new disability

Editor's Note

In this Canadian study, older patients with frailty were significantly more likely to die or experience a new disability within 90 days after surgery.

This prospective multicenter study included 702 patients, 65 years or older, having elective noncardiac surgery; 645 patients completed follow up. Frailty status was determined by the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS).

The CFS identified 297 (42.3%) with frailty, and the mFI identified 257 (36.6%). Of these 72 (11%) died or experienced a new disability.

In multivariable analysis, frailty was the only significant predictor of death or new disability. Need for institutional discharge, costs, and length of stay were significantly increased in frail patients.

Because the CFS was easier to use, required less time, and had less missing data, clinicians performing preoperative frailty assessments should consider the CFS over the mFI, the authors note.