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:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs ... College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. ... treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. ...
(Date:6/25/2016)... ... 25, 2016 , ... First Choice Emergency Room , the largest network ... the Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased ... location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/25/2016)... ... , ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department ... in recognition of their exemplary accomplishments in worksite health promotion. , The Wellness at ... Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one of 42 ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events ... turn to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. ... tools for healthy coping following a traumatic event. , Trauma sufferers tend to feel ...
(Date:6/24/2016)... ... 2016 , ... The Pulmonary Hypertension Association (PHA) learned during ... two significant new grants to support its work to advance research and patient ... recognizing patients, medical professionals and scientists for their work in fighting pulmonary hypertension ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Bracket , a leading clinical trial technology ... outcomes platform, Bracket eCOA (SM) 6.0, at the 52 ... 30, 2016 in Philadelphia , Pennsylvania.  A ... product of its kind to fully integrate with RTSM, will ... 6.0 is a flexible platform for electronic clinical outcomes assessments ...
(Date:6/23/2016)... , June 23, 2016 ... Oticon , industry leaders in advanced ... launch of Oticon Opn ™, the world,s first ... of possibilities for IoT devices.      (Photo: ... Oticon introduces a number of ,world firsts,: ...
(Date:6/23/2016)... 2016  Experian Health, the healthcare industry ... patient payment and care experience, today announced ... and services that will enhance the breadth ... These award-winning solutions will enable healthcare professionals ... in an ever-changing environment and redefine front-office ...
Breaking Medicine Technology: