Preop frailty screening improves outcomes

Editor's Note

Implementation of a frailty screening initiative was associated with reduced mortality in this study.

After implementing the initiative in 9,153 surgical patients, overall 30-day mortality for all patients, frail and nonfrail, decreased from 1.6% to 0.7%.

Postoperative mortality decreased significantly in frail patients at 30 (12.2% to 3.8%), 180 (23.9% to 7.7%), and 365 (34.5% to 11.7%) days.

Multivariate analysis showed a 3-fold survival benefit after controlling for age, frailty, and predicted mortality.

The researchers concluded that assessment of preoperative frailty in all patients is feasible and may be an effective tool for improving surgical outcomes for an aging and increasingly frail population.

Question Can surgical outcomes of frail patients be improved by facility-wide frailty screening and subsequent administrative review of perioperative surgical decision making? Findings After implementing a quality improvement project called the Frailty Screening Initiative in a prospective cohort of 9153 patients who underwent surgery, postoperative mortality decreased significantly at 30, 180, and 365 days.