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Frailty surgery

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https://www.readbyqxmd.com/read/29147763/frailty-in-end-stage-hip-or-knee-osteoarthritis-validation-of-the-groningen-frailty-indicator-gfi-questionnaire
#1
Jennifer M T A Meessen, Claudia S Leichtenberg, Claire Tilbury, Bart L Kaptein, Lennard A Koster, P Eline Slagboom, Suzan H M Verdegaal, Ron Onstenk, Henrike M J van der Linden-van der Zwaag, Herman Kaptijn, Stephan B W Vehmeijer, Willem-Jan C Marijnissen, Pieter-Jan Damen, Rob G H H Nelissen, Thea P M Vliet Vlieland
Frailty is highly prevalent in the elderly, increasing the risk of poor health outcomes. The Groningen Frailty Indicator (GFI) is a 15-item validated questionnaire for the elderly. Its value in patients with end-stage hip or knee osteoarthritis (OA) has not yet been determined. This study assesses the validity of the GFI in this patient group. End-stage hip or knee OA patients completed the GFI (range 0-15, ≥ 4 = frail) before arthroplasty surgery. Convergent validity was determined by Spearman-rank correlation between the SF-12 physical (PCS) and mental (MCS) component scores and the physical and mental GFI-domains, respectively...
November 17, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#2
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29129497/frailty-and-clinical-outcomes-in-advanced-heart-failure-patients-undergoing-left-ventricular-assist-device-implantation-a-systematic-review-and-meta-analysis
#3
Gary Tse, Mengqi Gong, Sunny Hei Wong, William K K Wu, George Bazoukis, Konstantinos Lampropoulos, Wing Tak Wong, Yunlong Xia, Martin C S Wong, Tong Liu, Jean Woo
BACKGROUND: Frailty has been identified as a risk factor for adverse clinical outcomes after cardiac intervention or surgery. However, whether it increases the risk of adverse outcomes in patients undergoing left ventricular assist device (LVAD) therapy has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and clinical outcomes of length of stay and mortality in this setting. METHODS: PubMed and Embase were searched until September 11, 2017, for studies evaluating the association between frailty and clinical outcomes in advanced heart failure patients undergoing LVAD implantation...
November 9, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29107159/assessment-of-a-novel-adult-cervical-deformity-frailty-index-as-a-component-of-preoperative-risk-stratification
#4
Emily K Miller, Tamir Ailon, Brian J Neuman, Eric O Klineberg, Gregory M Mundis, Daniel M Sciubba, Khaled M Kebaish, Virginie Lafage, Justin K Scheer, Justin S Smith, D Kojo Hamilton, Shay Bess, Christopher I Shaffrey, Christopher P Ames
OBJECTIVE: To determine the value of a novel adult cervical deformity frailty index (CD-FI) in preoperative risk stratification. METHODS: We reviewed a prospective, multicenter database of adults with cervical spine deformity. We selected 40 variables to construct the CD-FI using a validated method. Patients were categorized as not frail (NF) (<0.2), frail (0.2-0.4), or severely frail (SF) (>0.4) based on CD-FI score. We performed multivariate logistic regression to determine the relationships between CD-FI score and incidence of complications, length of hospital stay, and discharge disposition...
October 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29096604/predicting-operative-mortality-in-octogenarians-for-isolated-coronary-artery-bypass-grafting-surgery-a-retrospective-study
#5
Jessica G Y Luc, Michelle M Graham, Colleen M Norris, Sadek Al Shouli, Yugmel S Nijjar, Steven R Meyer
BACKGROUND: Available cardiac surgery risk scores have not been validated in octogenarians. Our objective was to compare the predictive ability of the Society of Thoracic Surgeons (STS) score, EuroSCORE I, and EuroSCORE II in elderly patients undergoing isolated coronary artery bypass grafting surgery (CABG). METHODS: All patients who underwent isolated CABG (2002 - 2008) were identified from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry...
November 2, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29076762/surgical-site-infection-after-transoral-versus-posterior-approach-for-atlantoaxial-fusion-a-matched-cohort-study
#6
Mohamed Macki, Azam Basheer, Ian Lee, Ryan Kather, Ilan Rubinfeld, Muwaffak M Abdulhak
OBJECTIVE In the past, spine surgeons have avoided the transoral approach to the atlantoaxial segment because of concerns for unacceptable patient morbidity. The objective of this study was to measure 30-day postoperative complications, especially surgical site infection (SSI), after transoral versus posterior approach to atlantoaxial fusion. METHODS The source population was provided by the American College of Surgeons National Surgical Quality Improvement Program database, which was queried for all patients who underwent atlantoaxial fusion for degenerative/spondylotic disease and/or trauma between 2005 and 2014...
October 27, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29073924/home-based-preoperative-rehabilitation-prehab-to-improve-physical-function-and-reduce-hospital-length-of-stay-for-frail-patients-undergoing-coronary-artery-bypass-graft-and-valve-surgery
#7
Iain Waite, Ranjit Deshpande, Max Baghai, Tania Massey, Olaf Wendler, Sharlene Greenwood
BACKGROUND: Evidence suggests that elective cardiac patients are at risk of functional and psychological deterioration in the time preceding surgery. This poses a risk to successful post-operative rehabilitation. This prospective one-group pre-test, post-test evaluation was designed to assess a clinical Pre-operative Rehabilitation (PREHAB) home-based exercise programme, to optimise pre-operative physical function and frailty in patients awaiting elective Coronary Artery By-Pass Graft (CABG) or Valve Surgery...
October 26, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29072428/long-term-disease-free-survival-of-non-metastatic-breast-cancer-patients-in-iran-a-survival-model-with-competing-risks-taking-cure-fraction-and-frailty-into-account
#8
Vahid Ghavami, Mahmood Mahmoudi, Abbas Rahimi Foroushani, Hossein Baghishani, Fatemeh Homaei Shandiz, Mehdi Yaseri
Introduction: Survival modeling is a very important tool to detect risk factors and provide a basis for health care planning. However, cancer data may have properties leading to distorted results with routine methods. Therefore, this study aimed to cover specific factors (competing risk, cure fraction and heterogeneity) with a real dataset of Iranian breast cancer patients using a competing risk-cure-frailty model. Materials and methods: For this historical cohort study, information for 550 Iranian breast cancer patients who underwent surgery for tumor removal from 2001 to 2007 and were followed up to March 2017, was analyzed using R 3...
October 26, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/29068797/alanine-aminotransferase-blood-levels-and-rehabilitation-outcome-in-older-adults-following-hip-fracture-surgery
#9
Irina Gringauz, Jonathan Weismann, Dan Justo, Abraham Adunsky, Gad Segal
Low alanine aminotransferase (ALT) blood levels are associated with frailty and poor outcome in older adults. Therefore, we studied the association between ALT blood levels before rehabilitation and rehabilitation outcome in older adults following hip fracture surgery. A total of 490 older adults (age>60 years, mean age: 82.9±6.7 years, 82.0% women) admitted to rehabilitation following hip fracture surgery were included. The rehabilitation outcome was assessed by Functional Independence Measure (FIM) scores...
October 24, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/29062740/outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-in-the-octogenarians-surgery-still-the-gold-standard
#10
Sameer A Hirji, Fernando Ramirez-Del Val, Ahmed A Kolkailah, Julius I Ejiofor, Siobhan McGurk, Ritam Chowdhury, Jiyae Lee, Pinak B Shah, Piotr S Sobieszczyk, Sary F Aranki, Marc P Pelletier, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Contemporary options for aortic valve replacement (AVR) include transcatheter and surgical approaches (TAVR and SAVR). As evidence accrues for TAVR in high and intermediate risk patients, some clinicians advocate that all patients aged over 80 years should only receive TAVR. Our aim was to investigate the utility of SAVR and minimally invasive AVR (mAVR) among octogenarians in the current era of TAVR. METHODS: From 2002 to 2015, 1,028 octogenarians underwent isolated AVR; 306 TAVR and 722 SAVR, of which 378 patients underwent mAVR...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29049457/association-of-patient-frailty-with-increased-morbidity-after-common-ambulatory-general-surgery-operations
#11
Carolyn D Seib, Holly Rochefort, Kathryn Chomsky-Higgins, Jessica E Gosnell, Insoo Suh, Wen T Shen, Quan-Yang Duh, Emily Finlayson
Importance: Frailty is a measure of decreased physiological reserve that is associated with morbidity and mortality in major elective and emergency general surgery operations, independent of chronological age. To date, the association of frailty with outcomes in ambulatory general surgery has not been established. Objective: To determine the association between frailty and perioperative morbidity in patients undergoing ambulatory general surgery operations. Design, Setting, and Participants: A retrospective cohort study was conducted of 140 828 patients older than 40 years of age from the 2007-2010 American College of Surgeons National Surgical Quality Improvement Program Participant Use File who underwent ambulatory and 23-hour-stay hernia, breast, thyroid, or parathyroid surgery...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29044631/frailty-hospital-volume-and-failure-to-rescue-after-head-and-neck-cancer-surgery
#12
Carrie L Nieman, C Matthew Stewart, David W Eisele, Peter J Pronovost, Christine G Gourin
OBJECTIVES/HYPOTHESIS: We previously reported that high-volume hospital head and neck cancer (HNCA) surgical care is associated with decreased mortality, largely explained by reduced rates of failure to rescue. Frailty is an independent predictor of mortality, but is significantly less likely in patients receiving high-volume care. We investigate whether differences in frailty rates explain the relationship between volume and outcomes in HNCA patients and whether frailty confounds the relationship between failure to rescue and mortality...
October 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29044598/comparison-of-common-risk-stratification-indices-to-predict-outcomes-among-stage-iv-cancer-patients-with-bowel-obstruction-undergoing-surgery
#13
Sarah B Bateni, Richard J Bold, Frederick J Meyers, Daniel J Canter, Robert J Canter
BACKGROUND AND OBJECTIVES: Among patients with disseminated malignancy (DMa), bowel obstruction is common with high operative morbidity. Since preoperative risk stratification is critical, we sought to compare three standard risk indices, the American Society of Anesthesiology (ASA) classification, Charlson comorbidity index (CCI), and modified frailty index (mFI). METHODS: We identified 1928 DMa patients with bowel obstruction who underwent an abdominal operation from 2007 to 2012 American College of Surgeons National Surgical Quality Improvement Program...
October 16, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29043526/chemoradiation-therapy-for-unresected-extrahepatic-cholangiocarcinoma-a-propensity-score-matched-analysis
#14
Anna Torgeson, Shane Lloyd, Dustin Boothe, George Cannon, Ignacio Garrido-Laguna, Jonathan Whisenant, Mark Lewis, Robin Kim, Courtney Scaife, Randa Tao
BACKGROUND: Unresected extrahepatic cholangiocarcinoma (uEHCC) remains a deadly disease. Guidelines for uEHCC recommend either chemotherapy alone (CT) or chemoradiotherapy (CRT). This study used the National Cancer Database (NCDB) to compare outcomes for patients treated with CT and those who underwent CRT. METHODS: Patients with initially diagnosed non-metastatic uEHCC from 2004 to 2014 were identified. Using Chi square analysis, patients who underwent CT were compared with those who received CRT...
October 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29034253/risk-factors-for-adverse-outcome-for-elderly-patients-undergoing-curative-oncological-resection-for-gastrointestinal-malignancies
#15
REVIEW
Yukai K Lim, Christopher Jackson, Emilia L Dauway, Konrad Klaus Richter
BACKGROUND: The incidence of gastrointestinal cancer increases with age, with approximately 20% of these cases in people over 80 years of age. Due to pre-existing comorbidities, this onco-geriatric population often presents diagnostic and therapeutic challenges. METHODS: A systematic review of articles on PubMed was performed to determine the predictive ability of screening tools and their components regarding the occurrence of adverse outcomes in elderly onco-surgical patients with gastrointestinal malignancies...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#16
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/29019118/frailty-correlates-with-postoperative-mortality-and-major-morbidity-after-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#17
Ioannis T Konstantinidis, Konstantinos Chouliaras, Edward A Levine, Byrne Lee, Konstantinos I Votanopoulos
BACKGROUND: Frailty is increasingly being recognized as a powerful predictor of postoperative outcomes for cancer patients. This study examined the role of the modified frailty index (MFI) in predicting outcomes for patients undergoing cytoreduction (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Data from National Surgical Quality Improvement Program (NSQIP) patients who underwent CRS/HIPEC between 2005 and 2014 were reviewed. The MFI, validated for use in NSQIP, was used to determine correlation between frailty and postoperative outcomes...
December 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29018814/the-impact-of-frailty-on-morbidity-and-mortality-following-open-emergent-colectomies
#18
Dominick V Congiusta, Prashanth Palvannan, Aziz M Merchant
BACKGROUND: Elderly and frail patients undergo open emergency colectomies and are at greater risk for complications. The relationship between frailty and open emergent colectomies is yet unexplored. OBJECTIVE: The purpose of this study was to evaluate the relationship between frailty and outcomes after open emergent colorectal surgery. DESIGN: Using the American College of Surgeons National Quality Improvement Program database, a validated modified frailty index was used, along with logistic regression, to assess the relationship between frailty and outcomes...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28990314/female-breast-cancer-management-and-survival-the-experience-of-major-public-hospitals-in-south-australia-over-3-decades-trends-by-age-and-in-the-elderly
#19
David Roder, Gelareh Farshid, Jim Kollias, Bogda Koczwara, Christos Karapetis, Jacqui Adams, Rohit Joshi, Dorothy Keefe, Caroline Miller, Kate Powell, Kellie Fusco, Marion Eckert, Elizabeth Buckley, Kerri Beckmann, Timothy Price
BACKGROUND: Clinical registry data from major South Australian public hospitals were used to investigate trends in invasive breast-cancer treatment and survival by age. METHODS: Disease-specific survival was calculated for the 1980 to 2013 diagnostic period using Kaplan-Meier product-limit estimates, with a censoring of live cases on December 31, 2014. Cox proportional hazards regression was used to examine differences in survival by age and tumour characteristic...
October 8, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28967731/new-assessment-for-advanced-age-italian-study-protocol-on-the-assessment-of-surgical-risk-in-the-over-75-year-age-group
#20
Annarita Pilleri, Giampaolo Scorcu
The role of age in the risk stratification of patients candidate for non-cardiac surgery is still today an unresolved issue. European guidelines, in contrast to American guidelines, do not attribute to age an independent role in increasing the risk, and the indices for assessment of perioperative cardiovascular risk are based on studies that were carried out on middle-aged subgroups of the population without specific attention to the elderly patient. While the indices of geriatric assessment have still not yet gained a standardized role in the risk stratification of patients candidate to non-cardiac surgery, their need is becoming increasingly urgent considering the epidemiological impact of elderly patients with multi-comorbidities who more and more in the future will undergo such interventions...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
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