The Limited Utility of the Hospital Frailty Risk Score as a Frailty Assessment Tool in Neurosurgery: A Systematic Review
Neurosurgery,
Год журнала:
2023,
Номер
unknown
Опубликована: Сен. 11, 2023
BACKGROUND
AND
OBJECTIVES:
The
Hospital
Frailty
Risk
Score
(HFRS)
is
an
International
Classification
of
Disease
10th
Revision-based
scale
that
was
originally
designed
for,
and
validated
in,
the
assessment
patients
75
years
or
older
presenting
in
acute
care
setting.
This
study
highlights
central
tenets
inherent
to
concept
frailty;
questions
logic
behind,
utility
of,
HFRS'
recent
implementation
neurosurgical
literature;
discusses
why
there
no
useful
role
for
HFRS
as
a
frailty-based
risk
(FBNRA)
tool.
METHODS:
authors
performed
systematic
review
literature
per
Preferred
Reporting
Items
Systematic
Reviews
Meta-Analyses
guidelines,
including
all
cranial
spinal
studies
used
their
primary
frailty
Seventeen
(N
=
17)
assess
frailty's
impact
on
outcomes.
Thirteen
total
journals,
10
which
were
highest
factor
published
17
papers.
RESULTS:
Increasing
score
associated
with
adverse
outcomes,
prolonged
length
stay
(11
studies),
nonroutine
discharge
(10
increased
hospital
costs
(9
studies).
Four
different
studies,
17,
predicted
one
following
4
outcomes:
worse
quality
life,
functional
reoperation,
in-hospital
mortality.
CONCLUSION:
Despite
its
rapid
acceptance
widespread
proliferation
through
leading
lacks
any
conceptual
relationship
syndrome
FBNRA
individual
patients.
measures
conditions
using
Revision
codes
awards
“frailty”
points
symptoms
examination
findings
unrelated
impaired
baseline
physiological
reserve
very
definition
frailty.
clinical
it
cannot
be
deployed
point-of-care
at
bedside
stratify
has
never
been
patient
population
younger
than
nonacute
We
recommend
discontinued
Язык: Английский
Influence of sarcopenia and frailty in the management of elderly patients with acute appendicitis
World Journal of Clinical Cases,
Год журнала:
2024,
Номер
12(33), С. 6580 - 6586
Опубликована: Сен. 27, 2024
In
developed
countries,
the
average
life
expectancy
has
been
increasing
and
is
now
well
over
80
years.
Increased
associated
with
an
increased
number
of
emergency
surgical
procedures
performed
in
later
age
groups.
Acute
appendicitis
one
most
common
diseases,
a
lifetime
risk
8%.
A
growing
incidence
acute
registered
elderly
population
oldest
groups
(>
years).
Among
patients
>
50-year-old
who
present
to
department
for
abdominal
pain,
15%
have
appendicitis.
these
patients,
surgery
challenging,
some
important
aspects
must
be
considered.
elderly,
treatment
outcomes
are
influenced
by
sarcopenia.
Sarcopenia
considered
precursor
frailty,
factor
physical
function
decline.
negative
impact
on
both
elective
regarding
mortality
morbidity.
Aside
from
morbidity
mortality,
crucial
older
requiring
reduction
decline
preoperative
maintenance.
Therefore,
prediction
critical.
surgery,
interventions
difficult
implement
because
narrow
time
window
before
surgery.
this
editorial,
we
highlight
unique
influence
sarcopenia
frailty
results
treatment.
Язык: Английский
The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol for Acute Appendicitis: Recommendations for Perioperative Care
Journal of Clinical Medicine,
Год журнала:
2024,
Номер
13(22), С. 6943 - 6943
Опубликована: Ноя. 18, 2024
Acute
appendicitis
(AA)
is
one
of
the
most
common
causes
emergency
department
visits
due
to
acute
abdominal
pain,
with
a
lifetime
risk
7-8%.
Managing
AA
presents
significant
challenges,
particularly
among
vulnerable
patient
groups,
its
association
substantial
morbidity
and
mortality.
Язык: Английский
The Hospital Frailty Risk Score Predicts Poor Prognoses in Middle-Aged and Older Patients With Acute Pancreatitis
Pancreas,
Год журнала:
2023,
Номер
52(4), С. e249 - e255
Опубликована: Апрель 1, 2023
Frailty
risk
may
be
associated
with
poor
prognoses
in
acute
pancreatitis
patients.
However,
this
has
not
been
shown
adjustments
for
prognosis-related
factors.
This
study
aimed
to
determine
whether
frailty
is
patients,
even
after
adjusting
factors.The
included
7001
middle-aged
and
older
patients
(mean
age,
66.2
±
14.5
years,
65.3%
male)
40
years
or
who
were
registered
a
Japanese
nationwide
database.
was
defined
as
Hospital
Risk
Score
≥5
points.
Outcomes
30-day
in-hospital
mortality,
length
of
stay,
readmission
rate.Frailty
independently
positively
mortality
(odds
ratio
[OR],
1.847;
95%
confidence
interval
[CI],
1.118-3.051)
(OR,
2.504;
CI,
1.677-3.739)
adjustment
severity
patient
characteristics.
In
addition,
longer
stay
(coefficient,
11.393;
9.631-13.154).
no
association
found
between
the
rate
1.092;
0.793-1.504).Our
findings
highlight
importance
rapid
automated
assessment
using
early
identification
high-risk
Язык: Английский
The Frailty Phenotype in Older Adults Undergoing Cochlear Implantation
Otology & Neurotology,
Год журнала:
2022,
Номер
43(10), С. e1085 - e1089
Опубликована: Окт. 3, 2022
To
prospectively
evaluate
the
frailty
phenotype
in
a
population
of
older
adults
and
determine
its
association
with
1)
perioperative
complications,
2)
need
for
vestibular
rehabilitation
after
surgery,
3)
early
speech
perception
outcomes.Prospective
cohort
study.Tertiary
care
hospital.Adults
than
65
years
undergoing
cochlear
implantation.The
Fried
Frailty
Index
was
used
to
classify
patients
as
frail,
prefrail,
or
not
frail
based
on
five
criteria:
gait
speed,
grip
strength,
unintentional
weight
loss,
4)
weekly
physical
activity,
5)
self-reported
exhaustion.Rates
intraoperative
postoperative
falls,
rehabilitation,
outcomes.Forty-six
were
enrolled
this
study.
Five
(10.8%)
categorized
10
(21.7%)
prefrail.
The
mean
ages
80.9,
78.8,
77.5,
respectively.
There
no
complications
among
all
groups.
Three
required
rehabilitation;
frail.
One
fall
occurred
nonfrail
individual.
Mean
(standard
deviation)
device
use
times
at
3
months
7.6
(3.5),
11.1
(3.6),
11.6
(2.9)
hours
per
day,
Consonant-nucleus-consonant
word
scores
surgery
13%
(12.2),
44%
(19.7),
51%
(22.4),
median
(range)
number
missed
follow-up
visits
(surgeon,
audiologist,
language
pathologist
combined)
7
(1-10)
patients,
compared
(0-4)
2
(0-5)
prefrail
patients.Frail
did
have
increased
rates
surgical
falls.
However,
experienced
challenges
accessing
care,
which
may
be
addressed
by
using
remote
programming
rehabilitation.
Язык: Английский
Effect of Intraspinal Anesthesia on Postoperative Recovery in Elderly Patients with Acute Appendicitis: A Retrospective Study
Annali Italiani di Chirurgia,
Год журнала:
2024,
Номер
95(4), С. 669 - 677
Опубликована: Авг. 20, 2024
Язык: Английский
Clinical significance of appendicoliths in elderly patients over eighty years old undergoing emergency appendectomy: A single-center retrospective study
World Journal of Gastrointestinal Surgery,
Год журнала:
2024,
Номер
16(11), С. 3453 - 3462
Опубликована: Окт. 30, 2024
BACKGROUND
Acute
appendicitis
with
an
appendicolith
is
one
of
the
most
common
abdominal
emergencies
in
elderly
patients
and
more
likely
to
progress
gangrene
perforation.
AIM
To
analyze
clinical
data
undergoing
emergency
appendectomy
for
acute
appendicitis,
aiming
improve
treatment
strategies.
METHODS
The
122
over
80
years
old
who
underwent
at
Department
Emergency
Surgery
Zhongshan
Hospital,
Fudan
University
from
January
2016
March
2023
were
retrospectively
analyzed.
divided
into
two
groups
based
on
presence
or
not,
clinicopathological
surgery-related
features
compared
between
groups.
RESULTS
duration
pain
all
ranged
5
168
h.
All
appendectomy:
6
had
open
appendectomy,
101
a
laparoscopic
15
required
conversion
surgery,
resulting
rate
12.9%
(15/116).
groups:
Appendicolith
group
(n
=
46)
non-appendicolith
76).
Comparisons
revealed
that
appendicoliths
develop
appendiceal
(84.8%
vs
64.5%,
P
0.010)
perforation
(67.4%
48.7%,
0.044),
lower
surgical
(2.2%
19.7%,
0.013).
median
length
hospital
stay
was
5.0
d
both
there
no
significant
difference
them.
successfully
discharged.
CONCLUSION
Around
40%
have
appendicolith,
increasing
their
risk
developing
perforation,
therefore
should
receive
timely
treatment.
Язык: Английский
New Perianal Sepsis Risk Score Predicts Outcome of Elderly Patients with Perianal Abscesses
Journal of Clinical Medicine,
Год журнала:
2023,
Номер
12(16), С. 5219 - 5219
Опубликована: Авг. 10, 2023
Antibiotic
therapy
following
surgical
perianal
abscess
drainage
is
debated,
but
may
be
necessary
for
high-risk
patients.
Frailty
has
been
shown
to
increase
the
risk
of
unfavorable
outcomes
in
elderly
This
study
aims
identify
patients
by
retrospectively
analyzing
a
single-center
cohort
and
using
pretherapeutic
score
predict
need
postoperative
antibiotics
extended
nursing
care
surgery.
The
sepsis
was
developed
through
univariable
multivariable
analysis.
Internal
validation
assessed
area
under
receiver-operating
characteristic
curve.
Elderly,
especially
frail
exhibited
more
severe
disease,
higher
frequency
antibiotic
therapy,
longer
hospitalization,
poorer
clinical
outcomes.
Multivariable
analysis
revealed
that
scores
5-item
modified
frailty
index,
severity
local
infection,
preoperative
laboratory
markers
infection
independently
predicted
prolonged
hospitalization
anti-infective
after
These
factors
were
combined
into
score,
which
demonstrated
better
predictive
accuracy
compared
with
chronological
age
or
status
alone.
Geriatric
assessments
are
becoming
increasingly
important
practice.
identifies
before
surgery,
enabling
early
initiation
allocation
additional
resources.
Язык: Английский
Utilização da escala de alvarado no diagnóstico da apendicite aguda em pacientes idosos
Programa de Iniciação Científica - PIC/UniCEUB - Relatórios de Pesquisa,
Год журнала:
2023,
Номер
unknown
Опубликована: Фев. 10, 2023
A
apendicite
aguda
(AA)
é
a
causa
mais
comum
de
abdome
agudo
cirúrgico
erepresenta
cerca
20%
das
intervenções
cirúrgicas,
com
5%
10%
dos
casos
ocorrendo
nosidosos.
Nesse
grupo,
apresentação
atípica
ou
inespecífica
da
doença
prejudica
odiagnóstico
precoce,
que
pode
ser
feito
através
do
Escore
Alvarado.
relevância
deinvestigar
AA
nos
idosos
justifica-se
pelo
aumento
na
incidência
doença,
peculiaridadesna
clínica,
diagnóstico
e
tratamento
desafiadores,
bem
como
por
maiores
taxasde
complicações,
maior
tempo
hospitalização,
pior
prognóstico
morbimortalidadeem
comparação
aos
jovens.
Trata-se
um
estudo
prospectivo,
observacional
descritivo,no
qual
se
analisou
utilização
Alvarado
no
em
pacientesacima
60
anos
operados
(grupo
amostra)
comparou-se
dados
semelhantesem
pacientes
18
30
anos,
também
controle),
quatrohospitais
regionais
Distrito
Federal.
Utilizou-se
instrumento
pesquisa
umquestionário
composto
informações
identificação,
pela
Escala
eperguntas
acerca
investigação
diagnóstica,
o
prontuário
eletrônicopara
demais
necessárias.
Segundo
os
critérios
analisados
escala,
ossintomas
prevalentes
amostra
foram
dor
quadrante
inferior
direito
náusease/ou
vômitos
(100%),
seguidos
sinal
Blumberg
presente
anorexia
(66,6%),leucocitose
abdominal
migratória
(33,3%).
Nenhum
paciente
apresentou
neutrofilia
efebre,
concordância
resultados
grupo
controle,
não
seobservou
febre.
Dentre
analisados,
33,3%
baixa
probabilidade
deapendicite,
possível
chance
provável
caso
AA.
Em
contraste,
100%do
controle
quase
confirmada.
Ademais,
amostra,
tempomédio
início
sintomas
até
internação
foi
90,6
horas,
intervalo
24
168horas,
enquanto
período
terapêutica
alta
variação,considerando
66,6%
operado
precocemente,
menos
5
formatardia,
horas.
duração
média
32
Dessa
forma,
éperceptível
importância
entendimento
análise
particular
pacientesidosos
aguda,
além
estratégias
métodos
melhorem
acurácia
epropiciem
precoce
dessa
patologia.
Sabe-se
deAlvarado
documentada
validada
jovens,
entretanto,
idosos,maiores
estudos
são
necessários
para
confirmar
eficácia
mesma
ferramentacomplementar
e,
assim,
propor
possíveis
modificações
parâmetros
interpretação,visando
neste
grupo.
Apesar
limitação
presenteestudo
demonstrou
faixa
etária
avançada
apresentam
menorespontuações
achado
concordantecom
literatura
atual,
reforça
necessidade
atenção
à
esses
grupo,considerando
suas
particularidades,
tornam
umdesafio