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https://hdl.handle.net/1959.11/51717
Title: | Frailty In Patients Undergoing Vascular Surgery: A Narrative Review Of Current Evidence |
Contributor(s): | Czobor, Nikoletta Rahel (author); Lehot, Jean-Jacques (author); Holndonner-Kirst, Eniko (author); Tully, Phillip J (author) ; Gal, Janos (author); Szekely, Andrea (author) |
Publication Date: | 2019-10-17 |
Open Access: | Yes |
DOI: | 10.2147/TCRM.S217717 |
Handle Link: | https://hdl.handle.net/1959.11/51717 |
Abstract: | | Frailty is presumably associated with an elevated risk of postoperative mortality and adverse outcome in vascular surgery patients. The aim of our review was to identify possible methods for risk assessment and prehabilitation in order to improve recovery and postoperative outcome. The literature search was performed via PubMed, Embase, OvidSP, and the Cochrane Library. We collected papers published in peer-reviewed journals between 2001 and 2018. The selection criterion was the relationship between vascular surgery, frailty and postoperative outcome or mortality. A total number of 52 publications were included. Frailty increases the risk of non-home discharge independently of presence or absence of postoperative complications and it is related to a higher 30-day mortality and major morbidity. The modified Frailty Index showed significant association with elevated risk for post-interventional stroke, myocardial infarction, prolonged in-hospital stays and higher readmission rates. When adjusted for comorbidity and surgery type, frailty seems to impact medium-term survival (within 2 years). Preoperative physical exercising, avoidance of hypalbuminemia, psychological and cognitive training, maintenance of muscle strength, adequate perioperative nutrition, and management of smoking behaviours are leading to a reduced length of stay and a decreased incidence of readmission rate, thus improving the effectiveness of early rehabilitation. Pre-frailty is a dynamically changing state of the patient, capable of deteriorating or improving over time. With goal-directed preoperative interventions, the decline can be prevented.
Publication Type: | Journal Article |
Source of Publication: | Therapeutics and Clinical Risk Management, v.15, p. 1217-1232 |
Publisher: | Dove Medical Press Ltd |
Place of Publication: | United Kingdom |
ISSN: | 1178-203X 1176-6336 |
Fields of Research (FoR) 2020: | 520304 Health psychology 520302 Clinical psychology |
Socio-Economic Objective (SEO) 2020: | 200409 Mental health 200502 Health related to ageing |
Peer Reviewed: | Yes |
HERDC Category Description: | C1 Refereed Article in a Scholarly Journal |
Appears in Collections: | Journal Article School of Psychology
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