Do first impressions count? Frailty judged by initial clinical impression predicts medium-term mortality in vascular surgical patients.

B. R O'Neill, Alan Batterham, A. C Hollingsworth, J. W Durrand, Gerard R. Danjoux

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Recognising frailty during pre-operative assessment is important. Frail patients experience higher mortality rates and are less likely to return to baseline functional status following the physiological insult of surgery. We evaluated the association between an initial clinical impression of frailty and all-cause mortality in 392 patients attending our vascular pre-operative assessment clinic. Prevalence of frailty assessed by the initial clinical impression was 30.6% (95% CI 26.0-35.2%). There were 133 deaths in 392 patients over a median follow-up period of 4 years. Using Cox regression, adjusted for age, sex, revised cardiac risk index and surgery (yes/no), the hazard ratio for mortality for frail vs. not-frail was 2.14 (95% CI 1.51-3.05). The time to 20% mortality was 16 months in the frail group and 33 months in the not-frail group. The initial clinical impression is a useful screening tool to identify frail patients in pre-operative assessment.
    Original languageEnglish
    Pages (from-to)684-691
    JournalAnaesthesia
    Volume71
    Issue number6
    DOIs
    Publication statusPublished - 28 Mar 2016

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