Frailty predicts increased hospital and six-month healthcare cost following colorectal surgery in older adults

Am J Surg. 2011 Nov;202(5):511-4. doi: 10.1016/j.amjsurg.2011.06.017. Epub 2011 Sep 3.

Abstract

Background: The purpose of this study was to determine the relationship of frailty and 6-month postoperative costs.

Methods: Subjects aged ≥ 65 years undergoing elective colorectal operations were enrolled in a prospective observational study. Frailty was assessed by a validated measure of function, cognition, nutrition, comorbidity burden, and geriatric syndromes. Frailty was quantified by summing the number of positive characteristics in each subject.

Results: Sixty subjects (mean age, 75 ± 8 years) were studied. Inpatient mortality was 2% (n = 1). Overall, 40% of subjects (n = 24) were considered nonfrail, 22% (n = 13) were prefrail, and 38% (n = 22) were frail. With advancing frailty, hospital costs increased (P < .001) and costs from discharge to 6-months increased (P < .001). Higher degrees of frailty were related to increased rates of discharge institutionalization (P < .001) and 30-day readmission (P = .044).

Conclusions: A simple, brief preoperative frailty assessment accurately forecasts increased surgical hospital costs and postdischarge to 6-month healthcare costs after colorectal operations in older adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colon / surgery*
  • Digestive System Surgical Procedures / economics*
  • Female
  • Frail Elderly*
  • Health Care Costs*
  • Hospital Costs*
  • Hospital Mortality
  • Humans
  • Institutionalization / economics
  • Male
  • Patient Discharge
  • Patient Readmission / economics
  • Patient Readmission / statistics & numerical data
  • Prospective Studies
  • Rectum / surgery*
  • United States