Is Frailty a Good Predictor of Postoperative Complications in Elective Abdominal Surgery?-A Single-Center, Prospective, Observational Study.

Abstract

Despite the common occurrence of postoperative complications in patients with frailty syndrome, the nature and severity of this relationship remains unclear. We aimed to assess the association of frailty with possible postoperative complications after elective, abdominal surgery in participants of a single-centre prospective study in relation to other risk classification methods. Frailty was assessed preoperatively using the Edmonton Frail Scale (EFS), Modified Frailty Index (mFI) and Clinical Frailty Scale (CFS). Perioperative risk was assessed using the American Society of Anesthesiology Physical Status (ASA PS), Operative Severity Score (OSS) and Surgical Mortality Probability Model (S-MPM). The frailty scores failed to predict in-hospital complications. The values of AUCs for in-hospital complications ranged between 0.5 and 0.6 and were statistically nonsignificant. The perioperative risk measuring system performance in ROC analysis was satisfactory with AUC ranging from 0.63 for OSS to 0.65 for S-MPM (p < 0.05 for each). The analysed frailty rating scales proved to be poor predictors of postoperative complications in the studied population. Scales assessing perioperative risk performed better. Further studies are needed to obtain optimal predictive tools in senior patients undergoing surgery.