The Gap Between Clinical Research and Standard of Care: A Review of Frailty Assessment Scales in Perioperative Surgical Settings

Stoicea, Nicoleta; Baddigam, Ramya; Wajahn, Jennifer; Sipes, Angela; Arias-Morales, Carlos E; Gastaldo, Nicholas; Bergese, Sergio D.

doi:10.3389/fpubh.2016.00150

Cited by 16 publications

(29 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been reported to take on average 5 minutes to complete and does not require someone with geriatric expertise to administer. 11 , 12 The assessment does incorporate a cognitive screen and screens for psychosocial determinants and has been validated as a tool to evaluate frailty. 11 , 12 , 13 …”

Section: Introductionmentioning

confidence: 99%

Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older

Owodunni¹,

Mostales

Qin³

et al. 2021

Journal of the American College of Surgeons

View full text Add to dashboard Cite

Introduction Preoperative discussion around postoperative discharge planning have been amplified by the COVID pandemic. We wish to determine if our preoperative frailty screen would predict postoperative LOI. Methods This single-institutional study included demographical, procedural, and outcome data from patients ≥65 years who underwent frailty screening prior to a surgical procedure. Frailty was assessed using the Edmonton Frailty Score (EFS). The Operative Severity Score was used to categorize procedures. The Hierarchical Condition Category (HCC) risk-adjustment score as calculated by CMS was included. LOI was defined as an increase in support outside of the home following discharge. Univariable, multivariable logistic regressions, and adjusted post-estimation analyses for predictive probabilities of best fit were performed. Results 535 patients met inclusion and LOI was seen in 38 (7%) patients. Patients with LOI were older, had a lower BMI, a higher EFS score (7vs.3.0, p<0.001), and a higher HCC score than patients without LOI. Being frail and undergoing a procedure with an OSS ≥ 3 was independently associated with an increased risk of LOI. In addition, social dependency, depression, and limited mobility was associated with an increased risk for LOI. On multivariable modeling, frailty status, undergoing a surgery with an OSS ≥ 3, and having an HCC score ≥ 1 was the most predictive of LOI (OR 12.72, 95% CI: 12.04, 13.44, p<0.001). In addition, self-reported depression, weight loss, and limited mobility was associated with a nearly 11-fold increase risk in postoperative LOI. Conclusions This study is novel as it identifies clear, generalizable risk factors for LOI. In addition, our findings support the implementation of preoperative assessments to aid in care coordination and provide specific targets for intervention.

show abstract

Section: Introductionmentioning

confidence: 99%

Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older

Owodunni¹,

Mostales

Qin³

et al. 2021

Journal of the American College of Surgeons

View full text Add to dashboard Cite

show abstract

“…There are literally dozens of tools designated to assess frailty, ranging from simple to multicomponent ( 10 , 11 , 12 , 13 , 14 , 15 , 18 , 26 ). There are two principal frailty models, namely: the phenotype model (Fried model or CHS Index) and the cumulative deficit model (Frailty index) ( 10 , 11 ).…”

Section: Resultsmentioning

confidence: 99%

Management of frailty at individual level – clinical management: Systematic literature review

Veninšek

Gabrovec

2018

Slovenian Journal of Public Health

View full text Add to dashboard Cite

IntroductionTo deliver quality management of a frail individual, a clinician should understand the concept of frailty, be aware of its epidemiology and be able to screen for frailty and assess it when it is present, and, finally, to recommend successful interventions.MethodologyA systematic literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published in the period from 2002 to 2017. From 67432 initial hits, 27 publications were selected.ResultsUseful interventions to address frailty are supplementation of vitamin D, proper nutrition, multicomponent training, home-based physiotherapy and comprehensive geriatric assessment, particularly when performed in geriatric wards.ConclusionComprehensive geriatric assessment is an effective way to decrease frailty status especially when performed in geriatric wards. Multicomponent physical training and multidimensional interventions (physical training, nutrition, vitamin D supplementation and cognitive training) are effective measures to reduce frailty.

show abstract

“…There are dozens of tools designated to assess frailty, ranging from simple to multicomponent tools (14,(16)(17)(18)(19)(20)(21)(22)(23). Furthermore, the gold standard for diagnosing and planning the treatment of frailty status is comprehensive geriatric assessment (CGA) (16).…”

Section: Clinical Managementmentioning

confidence: 99%

Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty

Gabrovec¹,

Antoniadou²,

Soleymani³

et al. 2020

J Rehabil Med

View full text Add to dashboard Cite

ADVANTAGE Joint Action is a project co-founded by the European Commission and the Member States, with the aim of building a common understanding of frailty on which to base an approach for older people who are frail or at risk. Based on a systematic review of the literature, including grey literature and good practice, where possible, this paper proposes some key interventions to tackle frailty. Prevention should be based on a multifaceted approach, addressing factors that have resonance across the individual's life course. All older people (over 70 years of age) should be offered a screening test and, if positive, referred for diagnosis. The management of frailty must be based on comprehensive geriatric assessment, to enable effective planning. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, as well as reduction in poly pharmacy and inadequate prescription are the most effective strategies to manage frailty. Objectives: ADVANTAGE Joint Action is a large collaborative project co-founded by the European Commission and its Member States to build a common understanding of frailty for Member States on which to base a common management approach for older people who are frail or at risk of developing frailty. One of the key objectives of the project is presented in this paper; how to manage frailty at the individual level. Methods: A systematic review of the literature was conducted, including grey literature and good practices when possible. Results: The management of frailty should be directed towards comprehensive and holistic treatment in multiple and related fields. Prevention requires a multifaceted approach addressing factors that have resonance across the individual's life course. Comprehensive geriatric assessment to diagnose the condition and plan a personalized multidomain treat ment improves outcomes. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, and reduction in polypharmacy and inadequate prescription, are the most effective strategies found in the literature to manage frailty effectively. Conclusion: Frailty can be effectively prevented and managed with a multidomain intervention strategy based on comprehensive geriatric assessment.

show abstract

The Gap Between Clinical Research and Standard of Care: A Review of Frailty Assessment Scales in Perioperative Surgical Settings

Cited by 16 publications

References 45 publications

Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older

Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older

Management of frailty at individual level – clinical management: Systematic literature review

Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty

Contact Info

Product

Resources

About