Navigation Links
Level of frailty predicts surgical outcomes in older patients, Johns Hopkins researchers find
Date:5/12/2010

A simple, 10-minute "frailty" test administered to older patients before they undergo surgery can predict with great certainty their risk for complications, how long they will stay in the hospital and most strikingly whether they are likely to end up in a nursing home afterward, new research from Johns Hopkins suggests.

"There's been this hunger to have some sort of scientific way to predict surgical outcomes in older people," says Martin A. Makary, M.D., M.P.H., an associate professor of surgery at the Johns Hopkins University School of Medicine and the study's leader. "We think we have a way now to accurately measure risk instead of eyeballing somebody or guessing."

The key is a means of measuring frailty using a five-point scale, developed at Johns Hopkins, Makary says. It includes loss of 10 pounds or more within the previous year, weakness as measured by a handheld dynamometer, exhaustion, low physical activity and slowed walking.

On the scale, one point is given for each problem. Scores of 4 or 5 mean that patients are considered frail; 2 or 3 mean they are considered intermediately frail. The test for frailty is simple to perform, taking just 10 minutes to complete.

In a study reported online and in the June issue of the Journal of the American College of Surgeons, Makary and his team applied the frailty test to 594 patients over age 65 who had elective surgery between July 2005 and July 2006. Results showed that patients who were frail were 2.5 times as likely as those who were not to suffer a postoperative complication, 1.5 times as likely to spend more time in the hospital and 20 times as likely to be discharged to a nursing home or assisted living facility after previously living at home.

Previous research has also linked frailty to poor outcomes even in patients not undergoing surgery and has associated frailty with mortality, morbidity, falls and increased hospitalization.

Surgeons have long known that some patients over age 65 do quite well after major surgery even though they appear feeble at the outset, while others who seem to be healthier before an operation emerge diminished. Predictive formulas based on cardiac health and medical history failed to stack up well against the new frailty score, the researchers found.

Makary says frailty is a relatively new clinical concept and is best defined as someone's physical reserve and ability to withstand stress to the body. Many patients considered medically healthy can be frail.

Approximately half of all operations in the United States are performed in patients over 65.

"Some surgeries are absolutely required no matter the risks and other surgeries are elective," Makary says. "A good frailty test can help patients and surgeons make more informed decisions."

At a minimum, providers who use the frailty score will be alerted to special needs and risks of older patients, he says. But having the information up front, he says, may enable providers to decrease the risk of complications in frail patients through closer monitoring and attention to hydration, nutrition and mobilization.

The research also found that using the frailty score strengthened the predictive ability of other commonly used risk assessment models for surgical patients.


'/>"/>

Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. The Incidence of Skin Cancer Has Reached Epidemic Levels
2. Eating Nuts May Help Cholesterol Levels
3. Endometrial stem cells restore brain dopamine levels
4. Cleveland Attorneys Recognized as Ohio Super Lawyers on 2010 List
5. Male obesity linked to low testosterone levels, study shows
6. Reading level of Medicaid renewal applications often too high
7. Clone Systems, Inc. Updates PCI Solutions for Level 1 & 2 Merchants
8. Race and empathy matter on neural level
9. SourceMedical Provides Ambulatory Surgery Centers with New Levels of Document Integration for Easy Access to Patient Data
10. Levels of Self-Esteem May Fluctuate Over Time
11. Increased EGFR levels may be an early marker of breast cancer
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/23/2017)... GREENVILLE, SC (PRWEB) , ... January 23, 2017 ... ... which is the premiere organization in North America for the scientific development, healthcare ... its 2017 Annual Scientific Session, and its 2017 AAT Member Certification Qualification Courses ...
(Date:1/23/2017)... ... January 23, 2017 , ... Steviva Ingredients, makers of all-natural ... USDA National Organic Program (NOP) for its Portland SQF Level 2 manufacturing facility. ... and handling systems to complement our current rigorous food-safety management systems,” said Yishu ...
(Date:1/23/2017)... ... January 23, 2017 , ... ... general gynecological care and gynecological services for women of all ages. ... for a wide variety of reproductive services from routine health screenings to diagnosing ...
(Date:1/23/2017)... ... ... “Life Under Blankets”: an entrancing story about one woman's travels through the ... creation of published author, Kimberly Mitchell, who earned her bachelor’s degree in English education ... a master’s degree in education in the field of curriculum and instruction. Kimberly’s passion ...
(Date:1/22/2017)... Boca Raton, FL (PRWEB) , ... January 22, 2017 , ... ... products to customers across the world, recently met with big-name retail buyers at the ... strong scientific evidence of efficacy and uses the utmost safety standards in all of ...
Breaking Medicine News(10 mins):
(Date:1/23/2017)... N.Y. , Jan. 23, 2017 LifeVac, ... from a blocked airway and prevented choking deaths, welcomes ... awareness advocate to the LifeVac team as Official Spokesperson. ... Steve join the LifeVac team," said Arthur Lih ... positioned to represent LifeVac and his mission to raise ...
(Date:1/23/2017)... , Jan 23, 2017 Research and Markets has ... & Trends - Product - Forecast to 2025" report to their ... Report Highlights: ... future market trends to identify the investment opportunities Market ... Key market trends across the business segments, Regions and Countries ...
(Date:1/23/2017)... January 23, 2017 Stock-Callers.com today presents ... (NASDAQ: CPRX ), Sophiris Bio Inc. (NASDAQ: ... ), and Agile Therapeutics Inc. (NASDAQ: AGRX ). ... somewhat lower in late trade on Friday, January 20 th ... 0.3%, while shares of health care companies in the S&P ...
Breaking Medicine Technology: