FIT-65: Frailty in the over 65’s undergoing elective surgery v2.91

• Research type

  Research Study

• Full title

  Frailty in the over 65’s undergoing elective surgery (FIT-65): A three-day study examining the prevalence of frailty in patients presenting for elective surgery across the Wessex deanery

• IRAS ID

  265846

• Contact name

  Sarah Harrison

• Contact email

  smesanderson@gmail.com

• Duration of Study in the UK

  0 years, 2 months, 0 days

• Research summary

  Research Summary
  An ageing population has led to increasing numbers of frail patients undergoing elective surgery. Due to the numerous tools used to assess frailty e.g. the Reported Edmonton Frail Scale (REFS) prevalence remains unclear. Frailty can be defined as a “distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves”. Frail individuals undergoing surgery are at increased risk of morbidity and mortality, but if identified early there are interventions that can improve their outcome.

  The primary objective of FIT-65 is to establish the prevalence of frailty in patients aged over 65 presenting for elective surgery in Wessex. It will also examine associations between frailty and:

  • Type and duration of anaesthesia
  • Seniority of staff caring for frail patients
  • Postoperative recovery
  • Length of hospital stay

  FIT-65 will aim to enrol patients in 8 Wessex hospitals. Data collection will take place during a 2 month study period over a period of three days in each hospital. The project will be conducted by doctors in training and not require additional funding.

  Theatre lists will be screened to identify eligible patients. Patients meeting inclusion criteria will be approached the morning of surgery and allocated an anonymised study number. A member of the research team will collect a pre-operative data set and a different researcher, unaware of the basic dataset, will complete the REFS with the participant before surgery.

  Following surgery a post-operative data set will be collected. The latter will not involve direct interaction with the participant.

  This study will allow us to better quantify the size of this vulnerable population, and may inform future work in improving their perioperative outcomes.

  Summary of Results
  Frailty is a condition related to the ageing process in which multiple body systems gradually lose their in-built reserves. It increases the risk of a patient suffering complications following surgery, the length of their hospital stay, and the need for assisted-living after discharge. As the UK population ages the number of frail patients needing non emergency surgery in the UK is likely to grow. Despite the potential benefits of early diagnosis, frailty is not uniformly screened for in UK elective surgical patients and its prevalence remains unclear. The primary aim of this study was to assess the prevalence of frailty in patients aged over 65 years undergoing elective surgery.

  Results
  Two hundred twenty eight participants were recruited during the study period of whom 218 went onto have surgery. There were 103 females and 115 males. Average age was 75 years. Thirty-seven participants (17.0%) were identified as frail. Frail patients were older, had a higher anaesthetic risk score, were more likely to have carers and were more likely to be anaemicor present with ECG (electrocardiogram) abnormalities. There were no differences in gender, body mass index, place of residence or smoking status for patients identified as frail compared to non-frail. There was no difference in length-of-hospital-stay between frail and non-frail patients, although those identified as frail were less likely to be discharged to their own home.

• REC name

  South Central - Hampshire B Research Ethics Committee

• REC reference

  20/SC/0121

• Date of REC Opinion

  2 Apr 2020

• REC opinion

  Favourable Opinion