A modified frailty index to assess morbidity and mortality after lobectomy

Tsiouris, Athanasios; Hammoud, Zane T.; Velanovich, Vic; Hodari, Arielle; Borgi, Jamil; Rubinfeld, Ilan

doi:10.1016/j.jss.2012.11.059

Cited by 233 publications

(154 citation statements)

References 28 publications

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“…28 Two studies involved vascular surgical patients 29,30 and two involved surgical oncology patients with either gynecological neoplasms 31 or gastric adenocarcinoma. 32 Two of the studies involved comprehensive surgical populations, 33,34 one study involved thoracic surgical patients undergoing lobectomy; 35 two studies used a mix of patients undergoing a mix of surgical procedures, 20,36 and one study involved patients undergoing a mix of minimally invasive surgical procedures. 37 All studies were published during 2009-2014.…”

Section: Basic Study Characteristicsmentioning

confidence: 99%

“…In eight studies, mortality was a perioperative outcome associated with frailty. 4,22,24,25,29,32,33,35 There was a wide variety of odds ratios (OR) for mortality reported in these studies, likely due to the variation in surgical population and frailty assessment used. For example, one study involving cardiac surgical patients reported an OR of 1.10 (95% confidence interval [CI] 1.04 to 1.16), 22 while another study conducted in patients undergoing esophagectomy reported a very high OR of 31.84.…”

Section: Frailty and Perioperative Surgical Outcomesmentioning

confidence: 99%

“…To highlight some of the more common assessments, five studies used a replica or modification of the Fried frailty criteria; 23,27,31,34,37 two studies used a replica or modification of the CSHA-FI based on an accumulation of deficits (where the more deficits accumulated the more frail the patient), 21,33 and four studies used a mFI. 25,28,29,35 The other studies utilized a range of frailty assessments, as outlined in Table 3. Clearly, there is a lack of consensus for a clear definition of frailty and for the best assessment tool to use in determining frailty status.…”

Section: Does This Review Mirror the Findings Of Others?mentioning

confidence: 99%

See 2 more Smart Citations

Frailty and perioperative outcomes: a narrative review

Beggs

Sepehri

Szwajcer

et al. 2014

Can J Anesth/J Can Anesth

141

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Background Frailty has no single universally accepted definition or method for assessment. It is commonly defined from a physiological perspective as a disruption of homeostatic mechanisms ultimately leading to a vulnerable state. Numerous scoring indices and assessments exist to assist clinicians in determining the frailty status of a patient. The purpose of this review is to discuss the relationship between frailty and perioperative outcomes in surgical patients. Principal findings We performed a review to determine the association of frailty with perioperative outcomes in patients undergoing a wide variety of surgical procedures. A scoping literature search was performed to capture studies from MEDLINE Ò , EMBASE TM , and CENTRAL (Cochrane), which resulted in locating 175 studies across the three electronic databases. After an article screening process, 19 studies were found that examined frailty and perioperative outcomes. The studies used a range of assessments to determine frailty status and included patients in a variety of surgical fields. Regardless of surgical population and method of frailty assessment, a relationship existed between adverse perioperative outcomes and frailty status. Frail patients undergoing surgical procedures had a higher likelihood than non-frail patients of experiencing mortality, morbidity, complications, increased hospital length of stay, and discharge to an institution. Conclusions Patients undergoing surgery who are deemed frail, regardless of the scoring assessment used, have a higher likelihood of experiencing adverse perioperative outcomes. With the lack of a unified definition for frailty, further research is needed to address which assessment method is most predictive of adverse postoperative outcomes.

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Section: Basic Study Characteristicsmentioning

confidence: 99%

Section: Frailty and Perioperative Surgical Outcomesmentioning

confidence: 99%

Section: Does This Review Mirror the Findings Of Others?mentioning

confidence: 99%

See 1 more Smart Citation

Frailty and perioperative outcomes: a narrative review

Beggs

Sepehri

Szwajcer

et al. 2014

Can J Anesth/J Can Anesth

141

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“…Frailty increases susceptibility to adverse health outcomes and contributes to the difference between chronological and physiological age 7. It is associated with increased mortality, surgical site infections, length of hospital stay, increased healthcare expenditure, and readmission rates in patients presenting for a variety of major noncardiac surgeries 8, 9, 10, 11, 12. Frailty has also been reported as a risk factor for mortality, major adverse cardiac and cerebrovascular events, and increased length of hospital stay in cardiac surgical patients 1, 2, 13, 14, 15, 16.…”

Section: Introductionmentioning

confidence: 99%

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Tran

Dupuis

et al. 2018

JAHA

104

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BackgroundFrailty is increasing in prevalence and poses a formidable challenge for clinicians. The cardiac surgery literature consists primarily of small single‐center studies with limited follow‐up, and the epidemiological features of frailty remain to be elucidated in long‐term follow‐up.Methods and ResultsWe conducted a population‐based, retrospective, cohort study in Ontario, Canada, between 2008 and 2015. Frailty was defined using the Johns Hopkins Adjusted Clinical Groups frailty indicator (a multidimensional instrument validated for research using administrative data). The primary outcome was mortality. Mortality rates were calculated using the Kaplan‐Meier method. The hazard of death was assessed using a multivariable Cox proportional hazard model. Of 40 083 patients, 8803 (22%) were frail. At 4±2 years of follow‐up, age‐ and sex‐standardized mortality rate per 1000 person‐years was higher in frail (33; 95% confidence interval, 29–36) compared with nonfrail (22; 95% confidence interval, 19–24) patients. Frailty was associated with an increased risk of long‐term mortality (adjusted hazard ratio, 1.20; 95% confidence interval, 1.12–1.28) and greater differences in the survival of patients between 40 and 74 years of age than in those who were ≥85 years old.ConclusionsFrailty was present in a large proportion of patients undergoing coronary artery bypass grafting and was independently associated with long‐term mortality. The adjusted risk of frailty‐related death was inversely proportional to age. Our findings highlight the need for more comprehensive preoperative risk stratification models to assist with optimal selection of operative candidates. In addition, we identified the <75 years age group as a potential target for comprehensive preoperative optimization programs, such as cardiac prehabilitation, nutritional augmentation, and psychosocial support.

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“…The patients were then objectively evaluated for frailty based on their medical records and the Modified Frailty Index (MFI) criteria [10] that included 11 items related to the overall health status and concomitant conditions. Patients were scored 1 for each criterion, and the total score was divided by 11.…”

Section: Methodsmentioning

confidence: 99%

Kruchość chorych kierowanych na operacje kardiochirurgiczne — badanie pilotażowe

et al. 2017

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Agnieszka Wiórek jest studentką VI roku Wydziału Lekarskiego z Oddziałem Lekarsko-Dentystycznym w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach. Obecnie pełni funkcję Przewodniczącej Studenckiego Koła Naukowego działającego pod kierownictwem dr. hab. n. med. Łukasza Krzycha przy Katedrze Anestezjologii i Intensywnej Terapii Uniwersyteckiego Centrum Klinicznego Śląskiego Uniwersytetu Medycznego w Katowicach. W przyszłości planuje rozpoczęcie szkolenia specjalizacyjnego z anestezjologii i intensywnej terapii oraz kontynuowanie rozwoju swojej działalności naukowej. W wolnym czasie trenuje jeździectwo. AbstractIntroduction. Frailty has been recently approved in many surgical fields as the acknowledged preoperative predictor of adverse postoperative complications. Several methods are available to assess frailty assessment which focus on different patient-related data. The aims of the study were: 1) to verify whether frailty may predict early postoperative complications in cardiac surgery; and 2) to investigate the agreement between objective and subjective assessment of frailty.

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A modified frailty index to assess morbidity and mortality after lobectomy

Cited by 233 publications

References 28 publications

Frailty and perioperative outcomes: a narrative review

Frailty and perioperative outcomes: a narrative review

Association of Frailty and Long‐Term Survival in Patients Undergoing Coronary Artery Bypass Grafting

Kruchość chorych kierowanych na operacje kardiochirurgiczne — badanie pilotażowe

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