A new frailty score derived from the comprehensive geriatric assessment may predict postoperative mortality in the elderly better than conventional methods, researchers conclude in JAMA Surgery.
Nearly 300 patients aged 65 and older who were undergoing elective surgery at a single hospital were scored on nine preoperative characteristics: malignancy, comorbidities, albumin level, activities of daily living, instrumental activities of daily living, dementia, delirium risk, malnutrition, and arm circumference. The highest potential score, indicating highest risk, was 15.
Compared with low-risk patients (score, 5 or lower), high-risk patients (above 5) had a higher 1-year mortality risk (hazard ratio, 9.01) and longer postoperative hospital stays (median, 9 vs. 6 days).
A commentator writes that this model predicted mortality better than the American Society of Anesthesiologists score: “This is a paradigm shift,” he says, “and it shows that we are now beginning to understand the true nature of age-related physiological changes in the patients on whom we operate.”