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658 Frailty predicts length of hospital stay in urology patients
Title
658
Frailty predicts length of hospital stay in urology patients Eur Urol Suppl 2015;14/2;e658
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Osborne C.1 , Charles A. 2 , Hare A. 2 , Shipway D.3 1 Imperial
College Healthcare Nhs Trust, Dept. Of Urology, London, United Kingdom, 2 Imperial College Healthcare Nhs Trust, Dept. of
Breast Surgery, London, United Kingdom, 3 Imperial College Healthcare Nhs Trust, Dept. of Medicine For The Elderly, London, United Kingdom INTRODUCTION & OBJECTIVES: Increasing numbers of older people are undergoing surgery, and yet advanced age is associated with adverse post-operative outcomes. Older people are a heterogenous group and there is increasing evidence that chronological age is less important than frailty in predicting mortality (Partridge et al., 2012). Frailty can be considered a syndrome of decreased physiological reserve which renders frail patients vulnerable to post-operative complications (Mitnitski et al., 2002) Frailty can be treated through multicomponent interventions including optimization of co morbidity, prehabilitation and nutritional support. Furthermore, comprehensive peri-operative geriatric assessment and optimization has been shown to reduce complications and length of stay in older surgical patients (Makary et al., 2010). Pre-operative frailty screening is therefore recommended by international guidelines (Chow et al, 2012). Where identified, it should prompt pre-operative geriatric medicine review, optimization and fully informed consent. Though frailty has been associated with adverse general surgical outcomes, there is little published data on its prevalence or predictive role in urology. MATERIAL & METHODS: Frailty screening was introduced on all urology patients aged ≥70 years admitted to our tertiary referral unit over a 10 week period. Frailty was assessed within 48 hours of admission using the Reported Edmonton Frail Scale (REFS). Scores ≥8 were deemed to indicate frailty (Hilmer et al., 2009). RESULTS: 132 urology patients aged ≥70 years were admitted during the study period and underwent frailty screening. Frailty was diagnosed in 38% (n=50). Frailty was more prevalent in emergency than elective admissions (55%, n=44 versus 30%, n=88). Frail patients had a significantly longer mean length of inpatient stay than non-frail (6.3 versus 2.6 days; p<0.001). CONCLUSIONS: Using the Reported Edmonton Frail Scale, the prevalence of frailty in urology patients has been found to be 38%. Frailty was significantly more prevalent in patients admitted with urological emergencies. Frail patients were found to have significantly increased length of stay, which may reflect increased complications and delayed discharge. These preliminary data reflect the vulnerability of older urology patients, especially those admitted with urological emergencies. These data suggest a need for closer collaboration between urology and geriatric medicine at a time of population ageing.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/658.html[19/02/2015 08:18:04]
658
Frailty predicts length of hospital stay in urology patients Eur Urol Suppl 2015;14/2;e658
Print! Print!
Osborne C.1 , Charles A. 2 , Hare A. 2 , Shipway D.3 1 Imperial
College Healthcare Nhs Trust, Dept. Of Urology, London, United Kingdom, 2 Imperial College Healthcare Nhs Trust, Dept. of
Breast Surgery, London, United Kingdom, 3 Imperial College Healthcare Nhs Trust, Dept. of Medicine For The Elderly, London, United Kingdom INTRODUCTION & OBJECTIVES: Increasing numbers of older people are undergoing surgery, and yet advanced age is associated with adverse post-operative outcomes. Older people are a heterogenous group and there is increasing evidence that chronological age is less important than frailty in predicting mortality (Partridge et al., 2012). Frailty can be considered a syndrome of decreased physiological reserve which renders frail patients vulnerable to post-operative complications (Mitnitski et al., 2002) Frailty can be treated through multicomponent interventions including optimization of co morbidity, prehabilitation and nutritional support. Furthermore, comprehensive peri-operative geriatric assessment and optimization has been shown to reduce complications and length of stay in older surgical patients (Makary et al., 2010). Pre-operative frailty screening is therefore recommended by international guidelines (Chow et al, 2012). Where identified, it should prompt pre-operative geriatric medicine review, optimization and fully informed consent. Though frailty has been associated with adverse general surgical outcomes, there is little published data on its prevalence or predictive role in urology. MATERIAL & METHODS: Frailty screening was introduced on all urology patients aged ≥70 years admitted to our tertiary referral unit over a 10 week period. Frailty was assessed within 48 hours of admission using the Reported Edmonton Frail Scale (REFS). Scores ≥8 were deemed to indicate frailty (Hilmer et al., 2009). RESULTS: 132 urology patients aged ≥70 years were admitted during the study period and underwent frailty screening. Frailty was diagnosed in 38% (n=50). Frailty was more prevalent in emergency than elective admissions (55%, n=44 versus 30%, n=88). Frail patients had a significantly longer mean length of inpatient stay than non-frail (6.3 versus 2.6 days; p<0.001). CONCLUSIONS: Using the Reported Edmonton Frail Scale, the prevalence of frailty in urology patients has been found to be 38%. Frailty was significantly more prevalent in patients admitted with urological emergencies. Frail patients were found to have significantly increased length of stay, which may reflect increased complications and delayed discharge. These preliminary data reflect the vulnerability of older urology patients, especially those admitted with urological emergencies. These data suggest a need for closer collaboration between urology and geriatric medicine at a time of population ageing.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/658.html[19/02/2015 08:18:04]