Editor's Note A new pilot study from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) finds that adding geriatric-specific risk factors to traditional risk factors could significantly improve the ability of surgeons to predict poor surgical outcomes in older patients. The study involved 36,399 older surgical…

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Editor's Note Frailty was associated with postoperative morbidity in patients having ambulatory general surgery procedures, independent of age, type of anesthesia, and other comorbidities, this study finds. In this study of 140,828 patients older than 40 years of age, frailty was associated with increased adjusted odds of 30-day morbidity after…

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Editor's Note In patients 85 years of age and older, surgical complexity and certain geriatric variables (malnutrition, frailty), which are overlooked in American Society of Anesthesiologists and most other scores, were relevant in predicting postoperative outcomes and mortality, finds this study. Of 127 patients who completed follow-up, 30-day mortality was…

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Editor's Note In this study, preadmission clinical frailty independently predicted adverse discharge destination (ie, death or discharge to a long-term, chronic or acute care facility) in geriatric trauma patients. The analysis of 266 trauma patients 65 years and older using the Clinical Frailty Scale (CFS) and the laboratory Frailty Index…

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Editor's Note Adding cognitive assessment to frailty assessment predicted poor postoperative outcomes and survival in frail patients better than either measurement alone, this study finds. The study included 330 patients having major surgery who were assessed with a four-level composite frailty scoring system, which was created by combining the Fried…

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Editor's Note Screening elderly patients preoperatively using the Vulnerable Elders Surgical Pathways and Outcomes Assessment (VESPA) tool helped identify patients at higher risk of postoperative complications in this study. A total of 736 patients 70 years of age or older were assessed in a preoperative clinic from July 9, 2008,…

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Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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Editor's Note Older patients who had major abdominal surgery and received interventions that included daily orienting communication, oral and nutritional assistance, and early mobilization were less likely to experience delirium and had a shorter hospital length of stay (LOS), this study finds. A total of 377 patients were included in…

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Editor's Note After emergency general surgery, frailty is associated with increased rates of mortality, discharge to an institution, and resource use, this Canadian study finds. Of 77,184 patients analyzed, 19,779 were frail. Death within 1 year of surgery occurred in 33.5% of frail patients, compared with 19.8% of nonfrail patients. Risk…

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Editor's Note The Coalition for Quality in Geriatric Surgery (CQGS) developed high-quality, valid standards to improve surgical care in the older adult, this study finds. A total of 306 of 308 standards developed were rated as valid to improve quality of geriatric surgery, 290 were rated as feasible, and 18…

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