Frailty, Frailty in Older Adults, Frailty/Sarcopenia
Conditions
Brief summary
Frailty is a significant risk factor for postoperative complications and functional decline. Preoperative assessment of frailty is therefore recommended in all older adults. However, despite the availability of many frailty tools, few have been tested in the preoperative setting and there is little comparison of their predictive value in identifying patients at risk. The aim of this study is to investigate which of the following instruments for determining frailty has the highest predictive power with regard to the occurrence of postoperative complications: Risk Analysis Index, Clinical Frailty Scale, the Groningen Frailty Indicator, the Edmonton Frail Scale and the LUCAS-FI. The aim of this research project is to identify a suitable frailty instrument for preoperative risk stratification of older patients during the premedication visit.
Interventions
OTHERAssessment of frailty using multiple tools
This is an observational study without any intervention. Frailty is assessed using multiple tools and postoperative outcome is compared.
Sponsors
Universitätsklinikum Hamburg-Eppendorf
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 70 years and older * scheduled surgery * estimated time of surgery 120 Minutes or more
Exclusion criteria
* insufficient German language skills (for cognitive testing) * mental retardation * relevant psychiatric disorder (not allowing for cognitive testing)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Complications in the first 30 days after surgery | 30 days | Measured by Clavien-Dindo classification |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional state (activities of daily living) | one, three and six months after surgery | Measured using WHO Disability Assessment Schedule 2.0 |
| Postoperative Quality of Recovery | postoperative day 2 | Measured by Quality-of-Recovery-15 questionnaire |
| Muscle loss during hospitalisation | From date of enrollment, up to 4 weeks after surgery | measured by bioimpedance prior to admission and before discharge from hospital |
| Postoperative delirium | postoperative day 1 to 5 | Measured by 3D-Confusion Assessment Method |
| Length of stay | from day of surgery, up to 4 weeks after surgery | days spent in hospital after surgery |
| Discharge destination | up to 4 weeks after surgery | e.g.:home, nursing home, other hospital |
| Cognitive state | 3 and 6 months after surgery | Using 5-Minute Montreal Cognitive Assessment (telephone-MOCA). A maximum of 15 points and a minumum of 0 points can be archieved; a higher score indicates better cognitive performance. |
| Quality-of-Life (QoL) | 3 and 6 months after surgery | Measured by WHO-Quality of Life in older adults (WHOQOL-OLD) questionnaire. The WHOQOL-OLD is evaluated by calculating scores for its six facets and summing them, with higher scores indicating a better perceived quality of life. |
| Frailty progression measured by LUCAS-FI | 3 and 6 months after surgery | Frailty assessment with Longitudinal Urban Cohort Aging Study Functional Index (LUCAS-FI)-questionnaire (telephone interview) The LUCAS-FI is evaluated by integrating both risk factors and protective resources, with the balance between them determining the degree of frailty. |
| Frailty progression measured by GFI (questionnaire) | 3 and 6 months after surgery | frailty assessment with Groningen Frailty Indicator (GFI) questionnaire (telephone interview). The GFI is evaluated by summing its item responses, with higher scores indicating a higher degree of frailty. |
| Frailty progression measured by EFS | 3 and 6 months after surgery | Frailty assessment by Edmonton Frail Scale (EFS), (score filled by physician, patient telephone interview). 1 to 10 points can be archieved, more points indicate a greater level of frailty. |
| Frailty progression by RAI measurement. The Risk Analysis Index (RAI) is evaluated by summing weighted risk factors and protective variables, with higher scores indicating greater patient vulnerability. | 3 and 6 months after surgery | Frailty assessment with Risk Analysis Index (index filled by physician, patient telephone interview) |
Countries
Germany
Contacts
CONTACTDr. Cynthia Olotu, MD
PRINCIPAL_INVESTIGATORDr. Cynthia Olotu, MD
University Medical Centre Hamburg
Outcome results
None listed