Comparison of three frailty measures for 90‐day outcomes of elderly patients undergoing elective abdominal surgery

BACKGROUND: To compare the predictive power of three different evaluation methods of frailty for 90‐day outcomes of elderly patients undergoing elective abdominal surgery. METHODS: A prospective cohort study was conducted with 194 patients and a postoperative follow‐up period of 90 days. Preoperative frailty was evaluated using the five‐item FRAIL questionnaire, 54‐item frailty index (FI), and nine‐item Clinical Frailty Scale (CFS). Receiver operating curves were used to compare the predictive ability for 90‐day mortality and long‐term hospitalization (LTH), and logistic regression was used to calculate odds ratios and 95% confidence intervals. RESULTS: The incidence rates of frailty assessed using FRAIL, FI, and CFS criteria were 43.8%, 32.5% and 36.6%, respectively. The 90‐day mortality and LTH of frail patients were significantly higher than those of non‐frail patients regardless of which criteria were used. The CFS and FI predicted 90‐day mortality better than FRAIL (CFS versus FRAIL: P = 0.005; FI versus FRAIL: P = 0.041), and the CFS predicted LTH better than FRAIL (P = 0.032). CONCLUSIONS: Patients diagnosed with frailty had significantly higher 90‐day mortality and LTH regardless of which criteria were used. The CFS and FI were better predictors of 90‐day mortality, and the CFS was a better predictor of LTH.