ArticleAnaesthesia2024
Impact of peri-operative frailty and operative stress on post-discharge mortality, readmission and days at home in Medicare beneficiaries.
Article in Anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- In older adults undergoing surgical fixation or arthroplasty following upper limb fractures, does frailty predict post-operative complications and mortality? A systematic review and meta-analysis.JSES reviews, reports, and techniques · 2026Review
- Effect of Hand Grip Strength on Perioperative Outcomes in Older Female Patients Scheduled for Total Knee Arthroplasty Under General Anesthesia-A Prospective Observational Study.Journal of clinical medicine · 2026Article
- Prevalence and associated factors of oral frailty in elderly patients undergoing elective surgery: a secondary analysis of a cross-sectional study.Frontiers in medicine · 2026Article
- The Clinical Frailty Scale is a valid and independent predictor of one-year survival in patients sustaining a hip fracture : scottish Hip Fracture Audit data from 8,092 patients.Bone & joint open · 2025Article
- The prognostic role of frailty on outcomes following meningioma resection in the elderly: a matched analysis employing baseline functional status.Acta neurochirurgica · 2025Article
- Time to surgery as a prehabilitation window: insights from United States Medicare data.Anaesthesia · 2025Article
- Frailty and Cardiac Complications after Minor and Major Noncardiac Surgery in Older Adults.Anesthesiology · 2025Article
- The Impact of Preoperative Risk Factors on Delayed Discharge in Day Surgery: A Meta-Analysis.Healthcare (Basel, Switzerland) · 2025Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundUnderstanding how patients' frailty and the physiological stress of surgical procedures affect postoperative outcomes may inform risk stratification of older patients undergoing surgery. The objective of the study was to examine the association of peri-operative frailty with mortality, 30-day readmission and days at home after non-cardiac surgical procedures of different physiological stress.
methodsThis retrospective study used Medicare claims data from a 7.125% random sample of Medicare fee-for-service beneficiaries from 2015 to 2019 who were aged ≥ 65 years and underwent non-cardiac surgical procedure listed in the Operative Stress Score categories. The exposure of the study was claims-based frailty index (robust, < 0.15; pre-frail, 0.15 to < 0.25; mildly frail, 0.25 to < 0.35; and moderate-to-severely frail, ≥ 0.35) with Operative Stress Score categories being 1, very low stress to 5, very high stress. The primary outcome was all-cause mortality at 30 days and 365 days after the surgical procedure.
resultsIn total, 1,019,938 patients (mean (SD) age of 76.1 (7.3) years; 52.3% female; 16.8% frail) were included. The cumulative incidence of mortality generally increased with Operative Stress Score category, ranging from 5.0% (Operative Stress Score 2) to 24.9% (Operative Stress Score 4) at 365 days. Within each category, increasing frailty was associated with mortality at 30 days (hazard ratio comparing moderate-to-severe frailty vs. robust ranged from 1.59-3.91) and at 365 days (hazard ratio 1.30-4.04). The variation in postoperative outcomes by patients' frailty level was much greater than the variation by the operative stress category.
conclusionsThese results emphasise routine frailty screening before major and minor non-cardiac procedures and the need for greater clinician awareness of postoperative outcomes beyond 30 days in shared decision-making with older adults with frailty.
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