ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Frailty in elderly patients with acute appendicitis.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 11 citations in OpenAlex.
- Review
- Clinical significance of appendicoliths in elderly patients over eighty years old undergoing emergency appendectomy: A single-center retrospective study.World journal of gastrointestinal surgery · 2024Article
- Influence of sarcopenia and frailty in the management of elderly patients with acute appendicitis.World journal of clinical cases · 2024Article
- The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol for Acute Appendicitis: Recommendations for Perioperative Care.Journal of clinical medicine · 2024Article
- New Perianal Sepsis Risk Score Predicts Outcome of Elderly Patients with Perianal Abscesses.Journal of clinical medicine · 2023Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
purposeAcute appendicitis in the elderly is becoming increasingly recognized for its often severe course. For various elective and urgent operations in older patients, frailty is a risk factor for poor outcomes. However, there is a lack of data on frailty in elderly patients with acute appendicitis.
methodsPatients over 65 years old who underwent surgery for acute appendicitis in three hospitals between January 2015 and September 2020 were assessed with the Hospital Frailty Risk Score (HFRS) and the modified Frailty Index (mFI). Outcomes of interest, including morbidity, mortality, and length of stay, were recorded.
resultsWhile frailty can be measured with both tests, the mFI has better applicability and takes significantly less time to implement compared to the HFRS (21.6 s vs. 80.3 s, p < 0.0001) while providing the same information value. Patients who exhibited frailty according to either assessment had a significantly higher rate of milder (OR 5.85/2.87, p < 0.0001/0.009) and serious (OR 4.92/3.61, p < 0.011/0.029) complications, more admissions to the intensive care unit (OR 5.16/7.36, p < 0.0001), and an almost doubled length of stay (12.7 days vs. 6.6 days, p < 0.005). Up to 31% of these patients required institutional care after discharge, which is significantly more than those without frailty (p < 0.0001). Furthermore, the mortality rate in frail patients was significantly elevated to 17%, compared to less than 1% in non-frail patients (p = 0.018).
conclusionIn elderly patients, frailty is a significant risk factor for negative outcomes. Frailty can be assessed more quickly and reliably with the mFI compared to the HFRS.
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