Increasing frailty may lead to death

February 19, 2019

A new study published in Age and Ageing indicates that frail patients in any age group are more likely to die than those who are not frail.

Worsening frailty at any age is associated with significantly poorer patient outcomes, but the relationship is unclear. Previously, studies on frailty have evaluated patients in terms of frail or not (with an intermediate category of "pre-frail" in between).

This study aimed to evaluate the prevalence of frailty its associated risk of mortality, readmission rate, and length of hospital stay in all adults, regardless of age, admitted as a surgical emergency. Researchers here assessed on a frailty scale with values from one to seven, with one indicating patients who were "robust, active, energetic, well-motivated and fit" and seven indicating patients who were severely frail; they were "completely dependent on others for activities of daily living, or terminally ill."

Researchers collected prospective patient data collated from six U.K. acute surgical units. The group studied included 2,279 patients. Researchers found that each incremental step of worsening frailty was associated with an 80% increase in mortality 90 days after initial admission. In addition, the frailest patients were increasingly likely to stay in hospitals longer, be readmitted within 30 days, and die within 30 days.

Surgeons are faced with challenging decision-making processes and it is not standard practice to reject a frail patient for emergency surgery based on their condition. This is the first study to assess frailty in adults of all ages admitted as a surgical emergency, finding that frailty exists in all age groups and is not exclusive to the older adult population. The researchers here demonstrated that there is an approximately linear relationship between increasing frailty and increased odds of mortality 90 days after initial admission; increasing frailty is associated with incrementally worsening outcomes.

"We found that patients fared worse as they become more frail," said the paper's lead author, Jonathan Hewitt. "This was true even in people who were classed as only slightly frail and got increasingly worse the frailer you were."
-end-
The paper, "Frailty Predicts Mortality in All Emergency Surgical Admissions regardless of Age. An observational study," is available at https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afy217/5281115

Direct correspondence to:

Dr Jonathan Hewitt
HewittJ2@cardiff.ac.uk

To request a copy of the study, please contact:

Daniel Luzer
daniel.luzer@oup.com

Sharing on social media? Find Oxford Journals online at @OxfordJournals

Oxford University Press USA

Related Mortality Articles from Brightsurf:

Being in treatment with statins reduces COVID-19 mortality by 22% to 25%
A research by the Universitat Rovira i Virgili (URV) and Pere Virgili Institut (IISPV) led by LluĂ­s Masana has found that people who are being treated with statins have a 22% to 25% lower risk of dying from COVID-19.

Mortality rate higher for US rural residents
A recent study by Syracuse University sociology professor Shannon Monnat shows that mortality rates are higher for U.S. working-age residents who live in rural areas instead of metro areas, and the gap is getting wider.

COVID-19, excess all-cause mortality in US, 18 comparison countries
COVID-19 deaths and excess all-cause mortality in the U.S. are compared with 18 countries with diverse COVID-19 responses in this study.

New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin
A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality.

Hydroxychloroquine reduces in-hospital COVID-19 mortality
An Italian observational study contributes to the ongoing debate regarding the use of hydroxychloroquine in the current pandemic.

What's the best way to estimate and track COVID-19 mortality?
When used correctly, the symptomatic case fatality ratio (sCFR) and the infection fatality ratio (IFR) are better measures by which to monitor COVID-19 epidemics than the commonly reported case fatality ratio (CFR), according to a new study published this week in PLOS Medicine by Anthony Hauser of the University of Bern, Switzerland, and colleagues.

COVID-19: Bacteriophage could decrease mortality
Bacteriophage can reduce bacterial growth in the lungs, limiting fluid build-up.

COPD and smoking associated with higher COVID-19 mortality
Current smokers and people with chronic obstructive pulmonary disease (COPD) have an increased risk of severe complications and higher mortality with COVID-19 infection, according to a new study published May 11, 2020 in the open-access journal PLOS ONE by Jaber Alqahtani of University College London, UK, and colleagues.

Highest mortality risks for poor and unemployed
Large dataset shows that income, work status and education have a clear influence on mortality in Germany.

Addressing causes of mortality in Zambia
Despite the fact that people in sub-Saharan Africa are now living longer than they did two decades ago, their average life expectancy remains below that of the rest of the world population.

Read More: Mortality News and Mortality Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.