Impact of Frailty on Postoperative Complications in Oncosurgery
Study Details
Study Description
Brief Summary
Advanced ageing is accompanied by loss of reserve in multiple organ systems leading to increased risk of complications after surgery.Frailty is a functional syndrome involving reduced physiological reserve and 25-56% of all elderly surgical patients are reported to be frail .
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Patients above 65 years age undergoing major Oncosurgery under general anaesthesia with or without Epidural will included , written informed consent will be obtained from all patients. Age, Heigth , Weigth , polypharmacy , smoking status , history of Diabetes ,Hypertension will be noted. Basic investigation Hb% , Serum Albumin , Serum creatinine will be done. ASA Physical status and Surgical risk will be noted .Patients will be evaluated for Frieds 5 point Frailty Assessment Scale (i) Unintended weigth loss of > 5kg in last one year.(ii) self reported exhaustion, (iii) muscle weakness (grip strength) (iv)slow walking speed,(v) Low physical activity and assigned to either No Frail Group (0 criteria) , Pre-Frail (1-2 positive criteria ), Frail (3-5 positive criteria Group).The assessment will be done in the preoperative anaesthesia clinic and include paper based questionnaire, hand dynamometer to measure muscle strength and walking test .
All patients will receive standard general anaesthesia along with Epidural for Abdomino-pelvic surgeries.Intraoperative monitoring 5 lead ECG, NIBP/IBP , SPO2, ETCO2, CVP(Optional),BIS will be done.After induction of anaesthesia Ultrasonography will be performed with curvilinear probe --- at the midpoint of femur anteriorly to measure Rectus Femoris muscle thickness of Right thigh , three consecutive readings will be measured and average of value noted for all patients.
At the end of surgery patient's neuromuscular block will be reversed and trachea extubated , if any patient requires ventilator support note will be made accordingly. Postoperative patients vitals and Input/Output charting will be done .Postoperative analgesia either epidural analgesia or intravenous opioids according to Institutional protocol will be given .Length of ICU Stay and any major cardiac , respiratory , Renal complications , re-exploration will be noted.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Non Frail Group The patients in no frail group did not have any component of Frailty criteria |
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| Pre Frail Group The patients in prefrail Group had 1-2 component of Frailty criteria. |
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| Frail Group The patients in Frail Group had 3-5 component of Frailty criteria. |
Outcome Measures
Primary Outcome Measures
- To study incidence of postoperative complications in frail patients [upto 7 days]
Postoperative major complications as myocardial infarction, Respiratory failure, cerebrovascular event, renal failure , re-exploration will be noted and statistically analysed.
Secondary Outcome Measures
- Length of ICU stay [upto 240 hours.]
Time from admission to the PACU to shifting to the ward will be noted in hours.
Eligibility Criteria
Criteria
Inclusion Criteria:
Patients undergoing major onco-surgey
Exclusion Criteria:
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Patient refusal to participate
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Age <65 years.
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Emergency surgery
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Pre-existing dementia
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Language barrier
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Rajiv Gandhi Cancer Institute and Research Centre | New Delhi | Delhi | India | 110085 |
| 2 | Rajiv Gandhi Cancer Institute | Delhi | India | 110085 |
Sponsors and Collaborators
- Rajiv Gandhi Cancer Institute & Research Center, India
Investigators
- Principal Investigator: Anita Kulkarni, MD, Rajiv Gandhi Cancer Institute and Research Centre , Delhi , India
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- RGCI Frailty