A prospective cohort study of older surgical inpatients examining the prevalence and implications of frailty.

Background: Older inpatients who are frail have complex medical issues and are likely to benefit from geriatric medicine services, but currently there are limited studies of frailty in the surgical inpatient population. The aims of this prospective cohort study were to identify the prevalence of frailty in a cohort of older surgical inpatients, and the association of frailty with adverse outcomes and provision of geriatric medicine assessment. Methods: Surgical inpatients aged ≥65 years admitted to a Sydney tertiary referral hospital were assessed for frailty using the Reported Edmonton Frail Scale. Outcomes in hospital and geriatrician involvement in inpatient care were identified by medical record review, and outcomes three months post-recruitment were assessed via telephone interview. Results: Of 100 participants, 33 were classified as frail. Frailty was associated with a higher risk of falls (P=0.01), disability in activities of daily living (P<0.001), polypharmacy (P<0.001) and new discharge to a nursing home (P=0.04). Prevalence of specialist geriatric assessment was not significantly greater in frail (36%) compared to non-frail (22%) participants. Conclusions: A significant proportion of frail surgical inpatients are vulnerable to adverse outcomes, but do not receive geriatric medicine services in the hospital setting. Preoperative frailty assessments have the potential to inform the management of these patients. [ABSTRACT FROM AUTHOR]