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Assessing the impact of frailty in elderly patients undergoing emergency laparotomies in Singapore.
Goh, Serene Si Ning; Zhao, Jiashen; Drakeford, Paul Andrew; Chen, Qingyan; Lim, Woan Wui; Li, Anthony Linajie; Chan, Kai Siang; Ong, Marc Weijie; Goo, Jerry Tiong Thye.
Afiliación
  • Goh SSN; General Surgery, Ministry of Health Holdings, Singapore.
  • Zhao J; General Surgery, Ministry of Health Holdings, Singapore.
  • Drakeford PA; Anaesthesia, Royal Prince Alfred Hospital, Sydney, Australia.
  • Chen Q; Anaesthesia, Tan Tock Seng Hospital, Singapore.
  • Lim WW; General Surgery, Khoo Teck Puat Hospital, Singapore.
  • Li AL; General Surgery, Ministry of Health Holdings, Singapore.
  • Chan KS; General Surgery, Ministry of Health Holdings, Singapore.
  • Ong MW; General Surgery, Khoo Teck Puat Hospital, Singapore.
  • Goo JTT; General Surgery, Khoo Teck Puat Hospital, Singapore.
Ann Acad Med Singap ; 53(6): 352-360, 2024 Jun 28.
Article en En | MEDLINE | ID: mdl-38979991
ABSTRACT

Introduction:

The global rise in ageing populations poses challenges for healthcare systems. By 2030, Singapore anticipates a quarter of its population to be aged 65 or older. This study addresses the dearth of research on frailty's impact on emergency laparotomy (EL) outcomes in this demographic, emphasising the growing significance of this surgical intervention.

Method:

Conducted at 2 tertiary centres in Singapore from January to December 2019, a retrospective cohort study examined EL outcomes in patients aged 65 or older. Frailty assessment, using the Clinical Frailty Scale (CFS), was integrated into demographic, diagnostic and procedural analyses. Patient data from Tan Tock Seng Hospital and Khoo Teck Puat Hospital provided a comprehensive view of frailty's role in EL.

Results:

Among 233 participants, 26% were frail, revealing a higher vulnerability in the geriatric population. Frail individuals exhibited elevated preoperative risk, prolonged ICU stays, and significantly higher 90-day mortality (21.3% versus 6.4%). The study illuminated a nuanced connection between frailty and adverse outcomes, underlining the critical need for robust predictive tools in this context.

Conclusion:

Frailty emerged as a pivotal factor influencing the postoperative trajectory of older adults undergoing EL in Singapore. The integration of frailty assessment, particularly when combined with established metrics like P-POSSUM, showcased enhanced predictive accuracy. This finding offers valuable insights for shared decision-making and acute surgical unit practices, emphasising the imperative of considering frailty in the management of older patients undergoing emergency laparotomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación Geriátrica / Anciano Frágil / Fragilidad / Laparotomía Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Asia Idioma: En Revista: Ann Acad Med Singap Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Singapur
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación Geriátrica / Anciano Frágil / Fragilidad / Laparotomía Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Asia Idioma: En Revista: Ann Acad Med Singap Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Singapur