A frailty index and the impact of frailty on postoperative outcomes in older patients after bariatric surgery.
BACKGROUND
The prognostic value of frailty in the elderly surgical population has been well studied across surgical specialties. However, no studies have yet explored the effects of frailty across the full spectrum of adverse events after bariatric surgery.


OBJECTIVES
To study the impact of index-frailty on the full range of adverse short-term outcomes after bariatric surgery.


METHODS
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data file for 2016 was used. Descriptive analyses, univariable, and multivariable regression models, assessed for discriminative and predictive capacities, were used to assess the effects of frailty on Clavien-Dindo categorized adverse outcomes within 30 days of bariatric surgery. Frailty index was modified from Canadian Study of Health and Aging Frailty Index.


SETTING
Data pooled from American Society for Bariatric Surgery-accredited bariatric surgery centers, United States.


RESULTS
A total of 21,426 patients aged ≥60 undergoing primary bariatric procedures were included. The prevalence of frailty as defined by the modified frailty index was 44.4%. Frail status was independently associated with higher odds of 30-day adverse events (Clavien-Dindo grades I, II, III, IV, and V). Frailty scores had weakly positive correlations with increasing age and increasing body mass index in the bariatric patients.


CONCLUSION
Frailty can be used as a risk stratification modality for patients before bariatric surgery. Further research should focus on exploring the relationship between obesity and frailty and the effects of weight loss on frailty status of bariatric patients.
['Gondal|Amlish Bilal|AB|', 'Hsu|Chiu-Hsieh|CH|', 'Zeeshan|Muhammad|M|', 'Hamidi|Mohammad|M|', 'Joseph|Bellal|B|', 'Ghaderi|Iman|I|']
D000368:Aged D050110:Bariatric Surgery D016208:Databases, Factual D005260:Female D000073496:Frailty D006801:Humans D008297:Male D008875:Middle Aged D009767:Obesity, Morbid D058996:Quality Improvement D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome D014481:United States
Frailty Outcomes Bariatric surgery Aging