Editor's Note The Risk Analysis Index (RAI) frailty screening tool, which was previously validated in the VA health system, can be efficiently implemented in multispecialty, multihospital healthcare systems to predict adverse postoperative outcomes, including mortality, readmission, and extended hospital stays, this study finds. From July 1 to December 31, 2016,…
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…
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…
Editor's Note The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator accurately predicted four quality-of-life outcomes that transcend traditional measures of successful surgery and now reflects the expected effects of surgery on an older patient’s ability to function independently, finds this study presented October…
Editor's Note In this study of patients with displaced femoral neck fractures, the incidence of secondary procedures did not differ significantly between patients who had total hip arthroplasty (THA) and those who had hemiarthroplasty. THA was associated with modestly better function over 2 years but with a slightly higher incidence…
Editor's Note Current rehabilitation practices may not be sufficient for hip fracture recovery in older adults, this study finds. A total of 210 patients from three US academic centers were randomized to a training intervention group (105 patients), which included aerobic, strength, balance, and functional training, or an active control…
Editor's Note In this study, postoperative delirium in patients averaging 80 years old was linked to long-term detrimental outcomes after major orthopedic surgical procedures. Of 130 patients analyzed, 34 developed postoperative in-hospital delirium. Patients with postoperative delirium had a greater decline in activities of daily living at 2 to 3…
Editor's Note In this study, women who averaged approximately 4,400 steps per day had significantly lower mortality rates than women who took approximately 2,700 steps per day. Of 16,741 women with a mean age of 72 years analyzed, their mean step count was 5,499 per day. A step volume of approximately…
Editor's Note In this study, postoperative delirium significantly increased the risk of postoperative cognitive dysfunction in older adults at 1 month after surgery, but there was no association at 2 and 6 months. Of 560 patients analyzed, 24% developed delirium during hospitalization. At 1 month after surgery, 47% had not…
Editor's Note Targeting a patient’s mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) by monitoring cerebral blood flow autoregulation may reduce the incidence of delirium after cardiac surgery in older patients, this Johns Hopkins study finds. In this analysis of 199 patients, the incidence of delirium was significantly greater in…