Frailty predicts need for medical review but not degree of organ support after complex orthopaedic surgery
© Singatoullina et al.; licensee BioMed Central Ltd. 2014
Published: 17 March 2014
Based on expert opinion and case note review, the UK National Confidential Enquiry into Peri-operative Outcome has recommended provision of perioperative level 2 and 3 care to support major surgery in older people, and particularly those with comorbidity . We wished to identify whether we could predict if the need was uniform and whether any factors could predict the degree of organ supports needed.
A total of 182 patients with a mean age of 69.8 years (range 29 to 92) were identified. Frail patients were significantly more likely to need additional medical input in the postoperative period whilst on critical care (Figure 1, P = 0.002) but this was not significantly linked to need for vasopressors, evidence of sepsis or choice of anaesthetic technique.
In complex revision orthopaedic surgery, the need for postoperative level 2/3 support cannot be predicted from any preoperative or intraoperative factors but patient frailty does indicate the need for medical input in the postoperative period.
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