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Abstract

Background: In older adults, frailty is a complex condition marked by diminished functional reserves and heightened susceptibility to stressors. It is a more accurate predictor of unfavorable postoperative outcomes in the context of surgical operations than a patient's age or preexisting medical problems. Objectives: This study aimed to investigate the effects of frailty, as assessed by the Clinical Frailty Scale (CFS) and the 5-item Modified Frailty Index (MFI-5), on important clinical outcomes, including length of stay in the intensive care unit (ICU), hospitalization mortality, and the chance of readmission within 30 days, in older adults undergoing major abdominal surgeries. Methods: A prospective observational study was conducted involving 90 elderly patients (mainly ≥70 years) undergoing abdominal surgery. Frailty was assessed preoperatively using both CFS and MFI-5. Postoperative outcomes were recorded, including mortality, ICU stay duration, and readmission. Statistical analysis included logistic regression, chi-square, and ROC curve evaluation to determine predictive performance. Results Frailty was significantly associated with increased ICU length of stay, complications, and mortality. The CFS (cutoff ≥6.5) demonstrated superior sensitivity (91.7%) and accuracy (92.8%) compared to MFI5 (cutoff ≥3.5), which had high specificity (93.9%) but lower sensitivity (54.2%). The presence of comorbidities such as diabetes and hypertension amplified the adverse impact of frailty on surgical outcomes. Conclusion: Frailty is a robust independent predictor of poor outcomes in elderly ICU patients, particularly following emergency surgery. The CFS outperforms MFI5 as a screening tool and should be incorporated into routine preoperative and critical care assessments. Early identification and multidisciplinary optimization of frail patients are essential to improving outcomes.

Article Type

Original Study

Subject Area

Anesthesia, Surgical Intensive Care and Pain Treatment

IRB Number

HSH00062

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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