Most Read Articles
Roshini Claire Anthony, 29 May 2020

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

5 days ago
Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
27 May 2020
The perception that proton pump inhibitors (PPIs) cause multiple serious adverse effects (AEs) is supported by many internists, who then recommend treatment cessation even in patients at high risk for upper gastrointestinal bleeding (UGIB), reveals a study.

Frailty worsens surgery outcomes in old patients

27 Feb 2020

Frailty is associated with poor 1-year outcomes in elderly patients undergoing emergency general surgery (EGS), a recent study reports.

Researchers conducted a retrospective analysis of 468,459 elderly adults who underwent partial colectomy, small bowel resection, peptic ulcer disease repair, adhesiolysis or laparotomy. A validated claims-based frailty index was used to identify those who were prefrail, mildly frail and moderately-to-severely frail.

A total of 175,336 participants (37.4 percent) were prefrail, while 12.4 percent (n=58,056) and 3.6 percent (n=16,803) were mildly and moderately-to-severely frail, respectively; the remaining 218,264 were nonfrail. Fourteen percent of patients with any frailty received palliative care during index hospitalization.

The 30-day mortality was 15.7 percent (n=73,666), which grew to 24.7 percent (n=115,687) by day 180 and further to 30.4 percent (n=102,365) at 1 year. Crude mortality was highest among those with the most severe frailty.

Multivariable analysis confirmed that the risk of 30-day mortality was significantly elevated in those with prefrailty, mild and moderate-to-severe frailty, relative to the nonfrail comparators. These effects were consistent at 180 days and at 1 year. Notably, those at the highest levels of frailty were more than twice as likely to die at 1 year than nonfrail participants (hazard ratio, 2.30, 95 percent confidence intervals, 2.24–2.35).

Similarly, 1-year postdischarge outcomes, such as emergency department visits, rehospitalizations, stay in the intensive care and total hospital encounters, were all significantly worse in patients with any frailty. Greater severities of frailty resulted in higher risks across all outcomes.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 29 May 2020

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

5 days ago
Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
27 May 2020
The perception that proton pump inhibitors (PPIs) cause multiple serious adverse effects (AEs) is supported by many internists, who then recommend treatment cessation even in patients at high risk for upper gastrointestinal bleeding (UGIB), reveals a study.