Study leader, Dr. Daniel McIsaac, said, “While the choice to proceed with an elective surgery must be weighed on a case-by-case basis, our findings support the need for thorough considerations of risk vs. benefit and the overall goals of care in frail patients considering major surgery.”
The researchers assessed physical frailty and death risk of over 200,000 people over the age of 65. All patients underwent elective non-cardiac surgery and three percent of the patients were considered frail.
Within a year post-surgery, 14 percent of the frail patients died – this in comparison with only five percent who were not frail but who died within the first year post-surgery.
Dr. Jason Johanning and his colleagues wrote in an accompanying editorial, “With this rigorous population-based, retrospective cohort study of surgical patients in Ontario, Canada, McIsaac and colleagues add to the growing literature demonstrating markedly increased risks frailty imposes on surgical populations.”
“Regardless of how frailty is measured, it still paints a picture of the same elephant: dramatically increased risks for postoperative mortality and morbidity. The elephant is now in our examination room and we, as surgeons, must address the optimal goals of care and honor patients’ preferences,” they concluded.