Association of Frailty With Post-Operative Outcomes of Older Adults Undergoing Elective Ostomy Reversal.

colorectal general surgery geriatrics

Journal

The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522

Informations de publication

Date de publication:
02 Aug 2023
Historique:
medline: 2 8 2023
pubmed: 2 8 2023
entrez: 2 8 2023
Statut: aheadofprint

Résumé

Ostomy reversal is a common surgical procedure; however, it is not without associated risks. Patient selection for this elective procedure is therefore critically important. Elderly patients represent a growing population and a substantial proportion of patients that present for evaluation after ostomy creation due to the most common etiologies. This study aims to assess the impact of frailty on the outcomes of ostomy reversal among older adults. Patients ≥65 years who underwent ostomy reversal from 2015 to 2019 were identified in the NSQIP database. Frailty was calculated using the 5-item Modified Frailty Index (MFI). Multivariate regression was performed to evaluate the association of frailty with post-operative 30-day mortality, 30-day serious complications, discharge to a facility, and 30-day readmission. A total of 13,053 patients were included, of which 18.7% were frail (MFI ≥ 2). Patients who underwent colostomy reversal had higher rates of serious complications ( Among older adults undergoing elective ostomy reversal, frailty is independently associated with increased odds of 30-day serious complications, discharge to facility, and 30-day readmission. As a potentially modifiable risk factor, identification of frailty offers the opportunity for shared decision-making and prehabilitation.

Sections du résumé

BACKGROUND BACKGROUND
Ostomy reversal is a common surgical procedure; however, it is not without associated risks. Patient selection for this elective procedure is therefore critically important. Elderly patients represent a growing population and a substantial proportion of patients that present for evaluation after ostomy creation due to the most common etiologies. This study aims to assess the impact of frailty on the outcomes of ostomy reversal among older adults.
METHODS METHODS
Patients ≥65 years who underwent ostomy reversal from 2015 to 2019 were identified in the NSQIP database. Frailty was calculated using the 5-item Modified Frailty Index (MFI). Multivariate regression was performed to evaluate the association of frailty with post-operative 30-day mortality, 30-day serious complications, discharge to a facility, and 30-day readmission.
RESULTS RESULTS
A total of 13,053 patients were included, of which 18.7% were frail (MFI ≥ 2). Patients who underwent colostomy reversal had higher rates of serious complications (
CONCLUSIONS CONCLUSIONS
Among older adults undergoing elective ostomy reversal, frailty is independently associated with increased odds of 30-day serious complications, discharge to facility, and 30-day readmission. As a potentially modifiable risk factor, identification of frailty offers the opportunity for shared decision-making and prehabilitation.

Identifiants

pubmed: 37528803
doi: 10.1177/00031348231191240
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

31348231191240

Auteurs

Caitlyn Braschi (C)

Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.

Garrett A Salzman (GA)

Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

Marcia M Russell (MM)

Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

Classifications MeSH