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Frailty is a significant risk factor for postoperative complications and functional decline. Preoperative assessment of frailty is therefore recommended in all older adults. However, despite the availability of many frailty tools, few have been tested in the preoperative setting and there is little comparison of their predictive value in identifying patients at risk. The aim of this study is to investigate which of the following instruments for determining frailty has the highest predictive power with regard to the occurrence of postoperative complications: Risk Analysis Index, Clinical Frailty Scale, the Groningen Frailty Indicator, the Edmonton Frail Scale and the LUCAS-FI. The aim of this research project is to identify a suitable frailty instrument for preoperative risk stratification of older patients during the premedication visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Older patients | Patients at 70 years and above scheduled for surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Assessment of frailty using multiple tools | Other | This is an observational study without any intervention. Frailty is assessed using multiple tools and postoperative outcome is compared. |
| Measure | Description | Time Frame |
|---|---|---|
| Complications in the first 30 days after surgery | Measured by Clavien-Dindo classification | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Functional state (activities of daily living) | Measured using WHO Disability Assessment Schedule 2.0 | one, three and six months after surgery |
| Postoperative Quality of Recovery | Measured by Quality-of-Recovery-15 questionnaire |
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Inclusion Criteria:
Exclusion Criteria:
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Patients of the Medical University Centre Hamburg, Germany
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dr. Cynthia Olotu, MD | Contact | 0049 40 7410 52415 | c.olotu@uke.de |
| Name | Affiliation | Role |
|---|---|---|
| Dr. Cynthia Olotu, MD | University Medical Centre Hamburg | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Medical Centre Hamburg | Hamburg | 22046 | Germany |
Strict data protection guidelines prevent patient data from being made available to third parties. In specific cases, anonymised data may be provided after individual examination and consultation with the responsible ethics committee.
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| ID | Term |
|---|---|
| D000073496 | Frailty |
| D055948 | Sarcopenia |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
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| postoperative day 2 |
| Muscle loss during hospitalisation | measured by bioimpedance prior to admission and before discharge from hospital | From date of enrollment, up to 4 weeks after surgery |
| Postoperative delirium | Measured by 3D-Confusion Assessment Method | postoperative day 1 to 5 |
| Length of stay | days spent in hospital after surgery | from day of surgery, up to 4 weeks after surgery |
| Discharge destination | e.g.:home, nursing home, other hospital | up to 4 weeks after surgery |
| Cognitive state | Using 5-Minute Montreal Cognitive Assessment (telephone-MOCA). A maximum of 15 points and a minumum of 0 points can be archieved; a higher score indicates better cognitive performance. | 3 and 6 months after surgery |
| Quality-of-Life (QoL) | Measured by WHO-Quality of Life in older adults (WHOQOL-OLD) questionnaire. The WHOQOL-OLD is evaluated by calculating scores for its six facets and summing them, with higher scores indicating a better perceived quality of life. | 3 and 6 months after surgery |
| Frailty progression measured by LUCAS-FI | Frailty assessment with Longitudinal Urban Cohort Aging Study Functional Index (LUCAS-FI)-questionnaire (telephone interview) The LUCAS-FI is evaluated by integrating both risk factors and protective resources, with the balance between them determining the degree of frailty. | 3 and 6 months after surgery |
| Frailty progression measured by GFI (questionnaire) | frailty assessment with Groningen Frailty Indicator (GFI) questionnaire (telephone interview). The GFI is evaluated by summing its item responses, with higher scores indicating a higher degree of frailty. | 3 and 6 months after surgery |
| Frailty progression measured by EFS | Frailty assessment by Edmonton Frail Scale (EFS), (score filled by physician, patient telephone interview). 1 to 10 points can be archieved, more points indicate a greater level of frailty. | 3 and 6 months after surgery |
| Frailty progression by RAI measurement. The Risk Analysis Index (RAI) is evaluated by summing weighted risk factors and protective variables, with higher scores indicating greater patient vulnerability. | Frailty assessment with Risk Analysis Index (index filled by physician, patient telephone interview) | 3 and 6 months after surgery |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D012816 | Signs and Symptoms |