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Screening for Frailty in Thoracic Surgical Patients. Ann Thorac Surg 2017 Mar;103(3):956-961

Date

10/11/2016

Pubmed ID

27720368

Pubmed Central ID

PMC5944327

DOI

10.1016/j.athoracsur.2016.08.078

Scopus ID

2-s2.0-84992116480 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

BACKGROUND: The presence of frailty or prefrailty in older adults is a risk factor for postsurgical complications. The frailty phenotype can be improved through long-term resistance and aerobic training. It is unknown whether short-term preoperative interventions targeting frailty will help to mitigate surgical risk. The purpose of this study was to determine the proportion of frail and prefrail patients presenting to a thoracic surgical clinic who could benefit from a frailty reduction intervention.

METHODS: A prospective cohort study was performed at a single-site thoracic surgical clinic. Starting October 1, 2014, surgical candidates 60 years of age or older who consented to be screened were included. Patients were screened using an adapted version of Fried's phenotypic frailty criteria: weakness (grip strength), slow gait (15-foot walk), unintentional weight loss, self-reported exhaustion, and low self-reported physical activity (Physical Activity Scale for the Elderly). Prefrailty was identified when participants demonstrated one to two frailty characteristics; frailty was identified when participants demonstrated three to five frailty characteristics.

RESULTS: Of 180 eligible patients, 126 consented, and 125 completed screening. Thirty-nine participants (31%) were not frail, 71 (57%) were prefrail, and 15 (12%) were frail. Exhaustion was the most common frailty symptom (34%). Frailty prevalence did not significantly differ among men and women (men: 10%, women: 14%; p = 0.75).

CONCLUSIONS: We found a high proportion of prefrail and frail patients among patients deemed candidates for thoracic surgical procedures. This finding indicates that frailty may be underrecognized. Substantial numbers of patients may be considered for a presurgical frailty reduction intervention.

Author List

Beckert AK, Huisingh-Scheetz M, Thompson K, Celauro AD, Williams J, Pachwicewicz P, Ferguson MK

Author

Angela K. Beckert MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Exercise
Fatigue
Female
Frail Elderly
Gait
Geriatric Assessment
Hand Strength
Humans
Male
Middle Aged
Patient Selection
Prevalence
Prospective Studies
Risk Factors
Self Report
Thoracic Surgical Procedures
Weight Loss