Too frail for surgery? A frailty index in major colorectal surgery

BackgroundFrailty is defined as increased vulnerability from accumulating morbidities in multiple organ systems. Evidence suggests frailty indices predict surgical outcomes in elderly patients. We assessed the validity of a frailty index in predicting post‐operative outcomes in major colorectal surgery.MethodsA retrospective review of a prospective database was studied. Patients aged less than 65 years were excluded. Patients were assessed using a validated National Surgical Quality Improvement Program frailty index. Endpoints included intensive care unit (ICU) stay, post‐operative complications and 30‐day post‐operative mortality, and also compared using American Society of Anesthesiologists (ASA) grade and P‐Possum CR.ResultsOf the 205 patients, 43 (21%) were frail and 162 (79%) were not frail. Seven percent of frail patients required ICU stay compared with 6% non‐frail patients (P > 0.05, NS). P‐Possum in frail versus non‐frail groups in ICU was 48% versus 8.6% (P < 0.05). Forty percent of frail and 26% non‐frail patients developed post‐operative complications (P > 0.05, NS) with mean P‐Possum of 23% versus 12% in these groups, respectively (P < 0.05). Five percent o