Featured Research

from universities, journals, and other organizations

Level of frailty predicts surgical outcomes in older patients, researchers find

Date:
May 13, 2010
Source:
Johns Hopkins Medical Institutions
Summary:
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 suggests.

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.

Other Johns Hopkins researchers involved in the study include Dorry L. Segev, M.D., Ph.D.; Peter J. Pronovost, M.D., Ph.D; Dora Syin, M.D.; Karen Bandeen-Roche, Ph.D.; Purvi Patel, M.D., M.P.H.; Ryan Takenaga, M.D.; Lara Devgan, M.D., M.P.H.; Christine G. Holzmueller, B.L.A.; and Jing Tian, M.S. Former Johns Hopkins faculty member Linda P. Fried, M.D., M.P.H., also contributed to the research.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Journal Reference:

  1. Martin A. Makary, Dorry L. Segev, Peter J. Pronovost, Dora Syin, Karen Bandeen-Roche, Purvi Patel, Ryan Takenaga, Lara Devgan, Christine G. Holzmueller, Jing Tian. Frailty as a Predictor of Surgical Outcomes in Older Patients. Journal of the American College of Surgeons, 2010; DOI: 10.1016/j.jamcollsurg.2010.01.028

Cite This Page:

Johns Hopkins Medical Institutions. "Level of frailty predicts surgical outcomes in older patients, researchers find." ScienceDaily. ScienceDaily, 13 May 2010. <www.sciencedaily.com/releases/2010/05/100512164339.htm>.
Johns Hopkins Medical Institutions. (2010, May 13). Level of frailty predicts surgical outcomes in older patients, researchers find. ScienceDaily. Retrieved July 23, 2014 from www.sciencedaily.com/releases/2010/05/100512164339.htm
Johns Hopkins Medical Institutions. "Level of frailty predicts surgical outcomes in older patients, researchers find." ScienceDaily. www.sciencedaily.com/releases/2010/05/100512164339.htm (accessed July 23, 2014).

Share This




More Health & Medicine News

Wednesday, July 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins