ArticleBJS open2024
Impact of clinical frailty on surgical and non-surgical complications after major emergency abdominal surgery.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Small bowel obstruction and frailty: a systematic review.European geriatric medicine · 2026Pooled it
- Trial
- Small bowel obstruction in older adults: similar nonoperative success but worse outcomes across management strategies - insights from the ESTES SnapSBO study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Article
- Advancing a patient-centered and holistic approach for older patients with frailty in a vascular surgical department: a quality improvement initiative.European geriatric medicine · 2026Article
- Emergency Ventral Hernia Management in Older Adults: A Retrospective Cohort Study and Structured Review of the Literature.Geriatrics (Basel, Switzerland) · 2026Article
- Postoperative pulmonary complications following major emergency abdominal surgery: incidence, risk factors, and outcomes-an observational study.Journal of anesthesia · 2026Article
- Impact of a Care Pathway for Older Patients Undergoing Emergency Abdominal Surgery: A Before-and-After Study.Acta anaesthesiologica Scandinavica · 2026Article
- Intraoperative complexity markers are associated with morbidity but not mortality in emergency abdominal surgery: a two-year cohort study.Langenbeck's archives of surgery · 2026Article
- ASO Author Reflections: The Evolving Evidence of Prehabilitation in Frail Cancer Patients Undergoing Surgery.Annals of surgical oncology · 2025Article
- High risk of short-term mortality and postoperative complications in patients with generalized peritonitis undergoing major emergency abdominal surgery-a cohort study.Langenbeck's archives of surgery · 2025Article
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Authors and funding
8 authors.
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Abstract
backgroundMajor emergency abdominal surgery is associated with a high risk of morbidity and mortality. Given the ageing and increasingly frail population, understanding the impact of frailty on complication patterns after surgery is crucial. The aim of this study was to evaluate the association between clinical frailty and organ-specific postoperative complications after major emergency abdominal surgery.
methodsA prospective cohort study including all patients undergoing major emergency abdominal surgery at Copenhagen University Hospital Herlev, Denmark, from 1 October 2020 to 1 August 2022, was performed. Clinical frailty scale scores were determined for all patients upon admission and patients were then analysed according to clinical frailty scale groups (scores of 1-3, 4-6, or 7-9). Postoperative complications were registered until discharge.
resultsA total of 520 patients were identified. Patients with a low clinical frailty scale score (1-3) experienced fewer total complications (120 complications per 100 patients) compared with patients with clinical frailty scale scores of 4-6 (250 complications per 100 patients) and 7-9 (277 complications per 100 patients) (P < 0.001). A high clinical frailty scale score was associated with a high risk of pneumonia (P = 0.009), delirium (P < 0.001), atrial fibrillation (P = 0.020), and infectious complications in general (P < 0.001). Patients with severe frailty (clinical frailty scale score of 7-9) suffered from more surgical complications (P = 0.001) compared with the rest of the cohort. Severe frailty was associated with a high risk of 30-day mortality (33% for patients with a clinical frailty scale score of 7-9 versus 3.6% for patients with a clinical frailty scale score of 1-3, P < 0.001). In a multivariate analysis, an increasing degree of clinical frailty was found to be significantly associated with developing at least one complication.
conclusionPatients with frailty have a significantly increased risk of postoperative complications after major emergency abdominal surgery, especially atrial fibrillation, delirium, and pneumonia. Likewise, patients with frailty have an increased risk of mortality within 90 days. Thus, frailty is a significant predictor for adverse events after major emergency abdominal surgery and should be considered in all patients undergoing major emergency abdominal surgery.
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