Royal Perth Hospital, Wellington St, Perth, Australia; Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch, Australia.
University of Western Australia, Nedlands, WA 6009, Australia.
Rev Esp Geriatr Gerontol. 2020 Mar-Apr;55(2):70-75. doi: 10.1016/j.regg.2019.09.005. Epub 2019 Dec 28.
Health professionals are progressively drawing on the concept of frailty as a determinant of adverse surgical outcomes in of older adults. We aimed to determine the prevalence of frailty and the correlation between frailty and mortality among older adults admitted to the acute surgical unit.
This prospective cohort study was conducted in the acute general surgical unit over a two month period. We recruited 150 consecutive patients aged 65yrs and above. The modified frailty index was employed to measure frailty and the albumin levels on admission were obtained from electronic medical records. The patients were followed up for a period of thirty days.
We found that more than 40% of the older adults admitted to the acute general surgical unit were frail and frailty was associated with higher rate of mortality at 30 days. Hypoalbuminemia was associated with a longer length of stay, higher rate of complications, and an increased likelihood of discharge to a rehabilitation facility. There was also a significant univariate correlation between frailty and the presence of hypoalbuminemia on admission.
Frailty and hypoalbuminemia are common in older general surgical patients and predict the likelihood of some of the adverse outcomes relevant to older adults and health economy such as mortality, increased length of stay, rate of complications, and likelihood of discharge to a rehabilitation facility. Further studies should investigate a possible causal association between frailty and low albumin levels in an acute surgical setting.
健康专业人员逐渐将脆弱性概念作为老年人不良手术结果的决定因素之一。我们旨在确定脆弱性的流行率以及脆弱性与急性外科病房老年患者死亡率之间的相关性。
这项前瞻性队列研究在两个月的时间内在急性普通外科病房进行。我们招募了 150 名年龄在 65 岁及以上的连续患者。采用改良的脆弱指数来衡量脆弱性，并从电子病历中获取入院时的白蛋白水平。对患者进行了 30 天的随访。
我们发现，超过 40%的入住急性普通外科病房的老年人身体虚弱，而且脆弱性与 30 天死亡率较高相关。低白蛋白血症与住院时间延长、并发症发生率较高以及更有可能出院到康复机构相关。入院时的脆弱性与低白蛋白血症之间也存在显著的单变量相关性。
虚弱和低白蛋白血症在老年普通外科患者中很常见，可预测与老年人和卫生经济相关的一些不良结局的可能性，如死亡率、住院时间延长、并发症发生率以及出院到康复机构的可能性。进一步的研究应该调查在急性外科环境中脆弱性和低白蛋白水平之间可能存在的因果关系。
