Assessment of Frailty Preoperatively and Loss of Independence in Elderly Surgical Patients

  • Ishfaq Ahmed Ahmed, Dr Neurosurgeon
  • Ishfaq Ahmed Ahmed, Dr Neurosurgeon
Keywords: loss of independence, Edmonton Frail Scale, Hierarchical Condition Category, Operative Severity Score


Objective:  This study was aimed to determine preoperative frailty assessment screening on postoperative morbidity and postoperative loss of independence (LOI).

Materials & Methods:  A total of 100 patient’s age 65 years and older were included in this study. Edmodium Frail Scale (EFS) was used for the assessment of frailty. The surgical procedure was categorized on operative severity score, and Hierarchical Condition Category (HCC). The Chi-square test was applied to see the significant/insignificant differences between different stratified groups of patients.

Results:  The mean age of the patients was 68 years. There were 63% male and 37% female patients. Maximum patients (78%) who had no LOI were in age less than 80 years. 11% of patients who had LOI were only 11%. There existed a significant difference (p-value: 0.004) between age groups (greater than/less than 80 years) of patients and presence/absence of loss of independence (LOI). After EFS assessment, 32% of patients had limited mobility, 22% had weight loss, 19% reported depression, 9% of patients were socially dependent and 18% reported cognitive impairment. 

Conclusion:  The results suggest that frail patients older than 78 years and OSS > 3 had a more increased risk of postsurgical LOI. The patients with EFS >5 and OSS >3 had more LOI. EFS analysis explained that those patients with restricted mobility, depression, and dependent socially had increased LOI. 

Author Biographies

Ishfaq Ahmed Ahmed, Dr, Neurosurgeon

Professor of Neurosurgery, Department of Neurosurgery, Qauid e Azam international Hospital, Islamabad

Ishfaq Ahmed Ahmed, Dr, Neurosurgeon

Professor of Neurosurgery, Department of Neurosurgery, Qauid e Azam international Hospital, Islamabad


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