Association between frailty assessment and death or walking disorders within postoperative 60 days in elderly patients undergoing major orthopedic surgery
Objective To explore the association between preoperative frailty and death or walking disorders within postoperative 60 days in elderly patients undergoing major orthopedic surgery.Methods A total of 441 elderly patients who underwent elective orthopedic surgery at the First People's Hospital of Nantong from March 2022 to April 2023 were in-cluded in the study.Preoperative frailty status was evaluated using the FRAIL scale,and baseline data,including age ad-justed Charlson comorbidity index(aCCI)scores were collected and evaluated.Patients were followed up to 60 days after surgery.Observe the primary outcome measures(death or walking disorders occurring 60 days after surgery)and second-ary outcome measures(first time out of bed,postoperative blood transfusion status,postoperative delirium status,inci-dence of surgery related complications,length of hospital stay and hospitalization costs).Multivariate logistic regression was used to investigate the relationship between preoperative frailty status and the occurrence of death or walking disorders within 60 days after surgery.Independent risk factors for death or walking disorders within 60 days after surgery were iden-tified,and the predictive value of frailty for death or walking disorders within 60 days after surgery was analyzed using re-ceiver operating characteristic(ROC)curve.Results Out of 441 patients,172 had preoperative frailty,with a frailty in-cidence rate of 39.0%.Among preoperative frailty patients,72 cases experienced death or walking disorders within 60 days after surgery,which was higher than that of preoperative non frailty patients(14 cases)and pre frailty patients(27 cases)(both P＜0.05).The results of multivariate logistic regression analysis showed that preoperative frailty was an inde-pendent risk factor for death or walking disorders within postoperative 60 days in elderly patients undergoing orthopedic sur-gery(OR=3.269,95%CI:1.597-6.692,P=0.001).The area under the ROC curve for predicting preoperative frailty and predicting death or walking disorders 60 days after surgery was 0.692,with a sensitivity of 63.7%and a specificity of 69.5%.Conclusions Preoperative frailty is an independent risk factor for death or walking disorders within postopera-tive 60 days in elderly patients undergoing major orthopedic surgery.
frailtyagedmajor orthopedic surgerycomplicationpreoperative period
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