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BioMed Research International
Volume 2017, Article ID 5126452, 10 pages
https://doi.org/10.1155/2017/5126452
Research Article

The Impact of Frailty on Morbidity and Mortality following Open Emergent Colectomies

New Jersey Medical School, Department of Surgery, Rutgers Biomedical and Health Sciences, Newark, NJ, USA

Correspondence should be addressed to Aziz M. Merchant; ude.sregtur@tnahcrem.ziza

Received 11 May 2017; Revised 12 July 2017; Accepted 31 July 2017; Published 6 September 2017

Academic Editor: Leungwing Chu

Copyright © 2017 Dominick V. Congiusta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Elderly and frail patients undergo open emergency colectomies and are at greater risk for complications. The relationship between frailty and open emergent colectomies is yet unexplored. Objective. The purpose of this study was to evaluate the relationship between frailty and outcomes after open emergent colorectal surgery. Design. Using the American College of Surgeons National Quality Improvement Program database, a validated modified frailty index was used, along with logistic regression, to assess the relationship between frailty and outcomes. Main Outcome Measures. Outcomes included mortality (primary), Clavien-Dindo Complication Grade >3, reintubation, ventilator >48 hours, and reoperation (secondary). Results. The rates for 30-day mortality, Clavien-Dindo Grade >3, reintubation, ventilator > 48 hours, and reoperation in our cohort were 16.6%, 36.9%, 8.6%, 23.9%, and 15.0%, respectively. There was a statistically significant increase in prevalence of all outcomes with increasing frailty. Limitations. A causal relationship between frailty and complications cannot be established in a retrospective analysis. Also, extrapolation of our data to reflect outcomes beyond 30 days must be done with caution. Conclusions. Frailty is a statistically significant predictor of mortality and morbidity after open emergent colectomies and can be used in an acute care setting.