Preop patient frailty, operative stress linked to postop mortality

Editor's Note

Even minor surgical procedures are associated with high risks for mortality in patients who are frail, finds this study.

In this retrospective analysis of 432,828 patients in the Veterans Administration Surgical Quality Improvement Program, frailty was associated with increased 30-, 90-, and 180-day mortality across all levels of operative stress.

The 30-day mortality rate was 1.55% for frail patients who had low-stress surgical procedures (eg, cystoscopy) and 5.13% for frail patients who had moderate-stress surgical procedures (eg, laparoscopic cholecystectomy). Both exceed the 1% mortality rate often used to define high-risk surgery.

For patients who were frail and very frail, mortality continued to increase at 90- and 180 days after moderate-stress surgical procedures, reaching 43% for very frail patients at 180 days.

The findings suggest that frailty screening should be used universally because even low- and moderate-stress procedures may pose a high risk for patients who are frail, the researchers say.