Among patients with a fatal outcome or ICU admission after elective THA or TKA, only 20% could be categorized as frail on the modified Frailty Index, suggests a study recently published in Acta Anaesthesiologica Scandinavica. Researchers have also elaborated that "further studies with a prospective design are needed to clarify the modified Frailty Index mFI as a risk stratification tool in elderly multimorbid patients undergoing elective arthroplasty surgery."
With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), a higher percentage of patients are identified with comorbidities that might increase the risk of complications. With this background, researchers aimed to elucidate the preoperative characteristics of patients with a fatal outcome or admission to the Intensive Care Unit (ICU) within 90 days after THA or TKA. The team arbitrarily hypothesized that more than 50% of those patients would be frail.
For the study protocol, preoperative characteristics of patients with a fatal outcome or admission to the Intensive Care Unit (ICU) within 90 days after total hip arthroplasty (THA) or total knee arthroplasty (TKA) were explored. Between 2010 and 2017, researchers designed a register-based, explorative study including patients undergoing elective, unilateral, primary THA or TKA in the Capital Region of Denmark, and who subsequently died or were admitted to the ICU within 90.The modified Frailty Index (mFI) was calculated from the medical records, and a score of ≥0.36 defined frailty.
Results highlighted some interesting facts.
The study enrolled a total of 33,758 patients who had undergone THA or TKA, and 284 patients (0.8%) died or were admitted to the ICU within 90 days.
Fifty-seven patients (20%) were frail (95% CI 16.2-25.7%).
The most common comorbidities were hypertension (63%) and pulmonary diseases (32%), and 56% used walking aids. Two or more comorbidities were present in 65% of patients, and 14% had no comorbidities at all.
For full article follow the link: https://doi.org/10.1111/aas.13950
Source: Acta Anaesthesiologica Scandinavica