Detection of the Frail Elderly at Risk of Postoperative Sepsis

Antonio Sarría-Santamera (), Dinara Yessimova, Dmitriy Viderman, Mar Polo-deSantos, Natalya Glushkova and Yuliya Semenova
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Antonio Sarría-Santamera: Department of Medicine, Nazarbayev University School of Medicine, 010000 Astana, Kazakhstan
Dinara Yessimova: Department of Medicine, Nazarbayev University School of Medicine, 010000 Astana, Kazakhstan
Dmitriy Viderman: Department of Medicine, Nazarbayev University School of Medicine, 010000 Astana, Kazakhstan
Mar Polo-deSantos: Agency for Health Technology Assessment, Institute of Health Carlos, 28029 Madrid, Spain
Natalya Glushkova: Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, 050040 Almaty, Kazakhstan
Yuliya Semenova: Department of Medicine, Nazarbayev University School of Medicine, 010000 Astana, Kazakhstan

IJERPH, 2022, vol. 20, issue 1, 1-9

Abstract: With the increase in the elderly population, surgery in aged patients is seeing an exponential increase. In this population, sepsis is a major concern for perioperative care, especially in older and frail patients. We aim to investigate the incidence of sepsis in elderly patients receiving diverse types of surgical procedures and explore the predictive capacity of the Hospital Frailty Risk Score (HFRS) to identify patients at high risk of incidence of postoperative sepsis. This study relies on information from the Spanish Minimum Basic Data Set, including data from nearly 300 hospitals in Spain. We extracted records of 254,836 patients aged 76 years and older who underwent a series of surgical interventions within three consecutive years (2016–2018). The HFRS and Elixhauser comorbidity index were computed to determine the independent effect on the incidence of sepsis. Overall, the incidence of postoperative sepsis was 2645 (1.04%). The higher risk of sepsis was in major stomach, esophageal, and duodenal (7.62%), followed by major intestinal procedures (5.65%). Frail patients are at high risk of sepsis. HFRS demonstrated a high predictive capacity to identify patients with a risk of postoperative sepsis and can be a valid instrument for risk stratification and vigilant perioperative monitoring for the early identification of patients at high risk of sepsis.

Keywords: sepsis; frail elderly; hospital frailty risk score; elixhauser comorbidity index; Spain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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